Provider Demographics
NPI:1013729060
Name:PRETTYMAN, CLAIRISA A (CMA)
Entity type:Individual
Prefix:
First Name:CLAIRISA
Middle Name:A
Last Name:PRETTYMAN
Suffix:
Gender:F
Credentials:CMA
Other - Prefix:
Other - First Name:RISSA
Other - Middle Name:
Other - Last Name:PRETTYMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CMA
Mailing Address - Street 1:PO BOX 8459
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97207-8459
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12360 SE SUNNYSIDE RD
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-9320
Practice Address - Country:US
Practice Address - Phone:503-303-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician