Provider Demographics
NPI:1558833970
Name:LIANG, ERIC (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:LIANG
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29345 SW TOWN CENTER LOOP E STE 110
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-8486
Mailing Address - Country:US
Mailing Address - Phone:503-582-2100
Mailing Address - Fax:
Practice Address - Street 1:29345 SW TOWN CENTER LOOP E STE 110
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-8486
Practice Address - Country:US
Practice Address - Phone:503-582-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-24
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA214248363A00000X, 363A00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program