Healthcare Provider Details

I. General information

NPI: 1083805220
Provider Name (Legal Business Name): DAVID CHARLES SENFT PA/MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 12/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19075 NW TANASBOURNE DRIVE SUITE 200
HILLSBORO OR
97124-5866
US

IV. Provider business mailing address

19075 NW TANASBOURNE DRIVE SUITE 200
HILLSBORO OR
97124-5866
US

V. Phone/Fax

Practice location:
  • Phone: 503-718-5512
  • Fax: 917-793-0205
Mailing address:
  • Phone: 503-718-5512
  • Fax: 917-793-0205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA01249
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA01249
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: