Provider Demographics
NPI:1740681311
Name:NORMAN, ROBIN JEAN (PA-C)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:JEAN
Last Name:NORMAN
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 1:545 SE OAK ST STE B
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4147
Mailing Address - Country:US
Mailing Address - Phone:503-654-7546
Mailing Address - Fax:503-786-3542
Practice Address - Street 1:545 SE OAK ST STE B
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4147
Practice Address - Country:US
Practice Address - Phone:503-654-7546
Practice Address - Fax:503-786-3542
Is Sole Proprietor?:No
Enumeration Date:2014-09-14
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPA2017-0002363A00000X
ORPA173787363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant