Provider Demographics
NPI:1619993185
Name:BIGLEN, DEENA L (PAC)
Entity Type:Individual
Prefix:
First Name:DEENA
Middle Name:L
Last Name:BIGLEN
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9155 SW BARNES RD STE 402
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6631
Mailing Address - Country:US
Mailing Address - Phone:503-292-7704
Mailing Address - Fax:503-292-7046
Practice Address - Street 1:9155 SW BARNES RD
Practice Address - Street 2:STE 402
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225
Practice Address - Country:US
Practice Address - Phone:503-256-0877
Practice Address - Fax:503-256-4188
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA01091363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical