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NPI Code Detail

MEDICARE: KERRY JONES ASHBY PA

MEDICARE:   KERRY JONES ASHBY  PA
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
1363AM0700XMedical Physician AssistantPA01454OR

General Provider Information

NPI Number : 1548403033
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERRY JONES ASHBY PA
Provider Business Mailing Address
First Line : 9485 SW WASHINGTON ST
Second Line :
City : PORTLAND
State : OR
Zip : 97225-6842
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3838 PACIFIC AVE
Second Line :
City : FOREST GROVE
State : OR
Zip : 97116-2224
Country : US
Telephone Number : 503-992-0288
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2009
Last Update Date : 02/04/2010

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Directions to “ KERRY JONES ASHBY PA” Practice Location

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