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NPI Code Detail

MEDICARE: ASHLEIGH FORD PA-C

MEDICARE:   ASHLEIGH  FORD  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
1363AM0700XMedical Physician AssistantPA201910OR

General Provider Information

NPI Number : 1780249193
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEIGH FORD PA-C
Provider Business Mailing Address
First Line : 2195 NE PROFESSIONAL CT STE 1
Second Line :
City : BEND
State : OR
Zip : 97701-6028
Country : US
Telephone Number : 541-322-9396
Fax Number : 541-322-9398
Provider Business Practice Location Address
First Line : 2195 NE PROFESSIONAL CT STE 1
Second Line :
City : BEND
State : OR
Zip : 97701-6028
Country : US
Telephone Number : 541-322-9396
Fax Number : 541-322-9398
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2019
Last Update Date : 11/09/2021

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Directions to “ ASHLEIGH FORD PA-C” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.