Path Solaris LLC

NPI #1609453992 in Portland, Oregon

Provider Information

NPI Number: 1609453992
Entity Type: Organization
Organization Name: Path Solaris LLC
Primary Specialty: Specialist
Enumeration Date: Mar 24, 2021
Last Updated: Mar 24, 2021

Practice Location

Address: 1842 NW 25TH AVE STE D
City: Portland
State: Oregon
ZIP Code: 97210-2568
Phone: (415) 254-4445

Authorized Official

Name: MICHELLE YAN, DSOM, LA.,
Title: DR
Phone: (415) 254-4445

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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