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General NPI Number Information
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NPI Number | 1093919268
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Entity Type | Organization
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Legal Business Name | JASON H NORDEAN
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 570 SE BASELINE ST
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City | HILLSBORO
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State | OR
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Zip | 97123-4114
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Country | US
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Telephone | 503-844-0777
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Fax | 503-648-9603
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Provider Business Mailing Address
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Address Line | 570 SE BASELINE ST
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City | HILLSBORO
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State | OR
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Zip | 97123-4114
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Country | US
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Telephone | 503-844-0777
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Fax | 503-648-9603
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MISS ANNA MEISNER
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Credential |
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Telephone | 503-844-0777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D8687
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License Number State | OR
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