Healthcare Provider Details

I. General information

NPI: 1538057385
Provider Name (Legal Business Name): DANIELLA MARIE WESTENBORG PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

849 PACIFIC AVE
HOOD RIVER OR
97031-1956
US

IV. Provider business mailing address

PO BOX 2038
PORTLAND OR
97208-2038
US

V. Phone/Fax

Practice location:
  • Phone: 541-386-6380
  • Fax: 541-639-4142
Mailing address:
  • Phone: 541-386-6380
  • Fax: 541-639-4142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA230102
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: