Provider Demographics
NPI:1063531333
Name:PAK, HELEN (DC)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:PAK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:
Other - Last Name:PAK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:12795 SW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-2704
Mailing Address - Country:US
Mailing Address - Phone:503-641-4244
Mailing Address - Fax:503-641-0551
Practice Address - Street 1:12795 SW 3RD ST
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-2704
Practice Address - Country:US
Practice Address - Phone:503-641-4244
Practice Address - Fax:503-641-0551
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3609111N00000X
OR201902023NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORHP1067806OtherHEALTH INSURANCE PROVIDER