MEDICARE: JASON RHOADES CFA

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	246ZC0007X	Surgical Assistant

General Provider Information

NPI Number	:	1861640740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON RHOADES CFA

Provider Business Mailing Address
First Line	:	1152 S 39TH ST
Second Line	:
City	:	SPRINGFIELD
State	:	OR
Zip	:	97478-9552
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1152 S 39TH ST
Second Line	:
City	:	SPRINGFIELD
State	:	OR
Zip	:	97478-9552
Country	:	US
Telephone Number	:	541-729-4456
Fax Number	:

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

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	09/03/2008

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Directions to “ JASON RHOADES CFA” Practice Location

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