MEDICARE: JADE TEIXEIRA PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA218522	OR

General Provider Information

NPI Number	:	1427834514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JADE TEIXEIRA PA-C

Provider Business Mailing Address
First Line	:	605 W OREGON AVE
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-1457
Country	:	US
Telephone Number	:	269-491-9963
Fax Number	:

Provider Business Practice Location Address
First Line	:	2821 DAGGETT AVE
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-1129
Country	:	US
Telephone Number	:	541-274-8400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2023
Last Update Date	:	04/01/2025

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Directions to “ JADE TEIXEIRA PA-C” Practice Location

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