Provider Demographics
NPI:1265612568
Name:UEHLIN, KRISTINA MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:MARIE
Last Name:UEHLIN
Suffix:
Gender:F
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 1:1010 SW COAST HWY STE 201
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-5240
Mailing Address - Country:US
Mailing Address - Phone:541-265-8816
Mailing Address - Fax:541-265-3890
Practice Address - Street 1:1010 SW COAST HWY STE 201
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-5240
Practice Address - Country:US
Practice Address - Phone:541-265-8816
Practice Address - Fax:541-265-3890
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA01294363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORPA01294OtherSTATE LICENSE