Healthcare Provider Details

I. General information

NPI: 1033998679
Provider Name (Legal Business Name): ANA COLE PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18081 SW LOWER BOONES FERRY RD STE 2
TIGARD OR
97224-7290
US

IV. Provider business mailing address

18081 SW LOWER BOONES FERRY RD STE 2
TIGARD OR
97224-7290
US

V. Phone/Fax

Practice location:
  • Phone: 503-673-3893
  • Fax:
Mailing address:
  • Phone: 503-673-3893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA228086
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: