Healthcare Provider Details

I. General information

NPI: 1033028162
Provider Name (Legal Business Name): JEAN M PACEWIC DMD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1554 GARDEN ST STE 104
WEST LINN OR
97068-3278
US

IV. Provider business mailing address

1554 GARDEN ST STE 104
WEST LINN OR
97068-3278
US

V. Phone/Fax

Practice location:
  • Phone: 503-655-9300
  • Fax: 503-212-0122
Mailing address:
  • Phone: 503-655-9300
  • Fax: 503-212-0122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JEAN PACEWIC
Title or Position: OWNER/DENTIST
Credential: DMD
Phone: 503-201-9483