Provider Demographics
NPI:1730466178
Name:GUIDO, KARYN VIRGINIA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:KARYN
Middle Name:VIRGINIA
Last Name:GUIDO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19075 NW TANASBOURNE DR
Mailing Address - Street 2:STE 200
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124
Mailing Address - Country:US
Mailing Address - Phone:503-941-3753
Mailing Address - Fax:503-941-3777
Practice Address - Street 1:202 NW 13TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209
Practice Address - Country:US
Practice Address - Phone:503-941-3753
Practice Address - Fax:503-941-3777
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085004149363A00000X
ORPA156552363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant