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General NPI Number Information
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NPI Number | 1962069062
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Entity Type | Organization
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Legal Business Name | HELEN H PAK DC FNP LLC
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Dates
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Enumeration Date | 05/23/2019
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Last Update Date | 05/23/2019
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Provider Practice Location Address
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Address Line | 12795 SW 3RD ST
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City | BEAVERTON
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State | OR
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Zip | 97005-2704
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Country | US
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Telephone | 503-641-4244
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Fax | 503-641-0551
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Provider Business Mailing Address
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Address Line | 12795 SW 3RD ST
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City | BEAVERTON
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State | OR
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Zip | 97005-2704
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Country | US
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Telephone | 503-641-4244
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Fax | 503-641-0551
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | HELEN PAK
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Credential | FNP
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Telephone | 503-641-4244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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