person
Mr. Cody Lee Ballard, PA-C
Medical Physician Assistant in Portland, Oregon
NPI 1710258066

Cody Lee Ballard is a Medical Physician Assistant based in Portland, OR and is specialized in Medical. Cody Lee Ballard practices in Portland, OR and has the professional credentials of PA-C. The NPI Number for Cody Lee Ballard is 1710258066 and holds a License No. PA164961 (Oregon).

The current practice location address for Cody Lee Ballard is 3181 Sw Sam Jackson Park Rd, Portland, OR and can be reached out via phone at 503-438-8822.

Location: 3181 Sw Sam Jackson Park Rd, Portland, OR, 97239-3011
person
Provider Profile Details
NPI Number
1710258066
Provider Name
Cody Lee Ballard
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
3181 Sw Sam Jackson Park Rd, Portland, OR, 97239-3011
Phone Number
503-438-8822
Fax Number
Provider Enumeration Date
01/18/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3181 Sw Sam Jackson Park Rd
City
State
Zip
97239-3011
Phone Number
503-438-8822
Fax Number
person
Provider Business Mailing Address Details
Address
3181 Sw Sam Jackson Park Rd
City
State
Zip
97239-3011
Phone Number
503-438-8822
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA164961 (Oregon)
Definition
Definition to come...
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