Provider Demographics
NPI:1770716763
Name:PANDZIK, ALEX MICHAEL (NP)
Entity type:Individual
Prefix:MR
First Name:ALEX
Middle Name:MICHAEL
Last Name:PANDZIK
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Gender:M
Credentials:NP
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Mailing Address - Street 1:2051 KAEN RD
Mailing Address - Street 2:SUITE 367
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-4035
Mailing Address - Country:US
Mailing Address - Phone:503-742-5300
Mailing Address - Fax:503-742-5979
Practice Address - Street 1:9775 SE SUNNYSIDE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-5739
Practice Address - Country:US
Practice Address - Phone:503-655-8471
Practice Address - Fax:503-723-4907
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2016-10-18
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Provider Licenses
StateLicense IDTaxonomies
OR201250022NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily