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NPI Code Detail

MEDICARE: JASON E BROWN PAC

MEDICARE: JASON E BROWN PAC
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
1363A00000XPhysician AssistantPA156782OR

General Provider Information

NPI Number : 1881966893
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON E BROWN PAC
Provider Business Mailing Address
First Line : PO BOX 2847
Second Line :
City : CORVALLIS
State : OR
Zip : 97339-2847
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 199 W HIGHWAY 20
Second Line :
City : TOLEDO
State : OR
Zip : 97391-1242
Country : US
Telephone Number : 541-574-2730
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2012
Last Update Date : 03/15/2021

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Directions to “ JASON E BROWN PAC” Practice Location

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