Individual
MR. JOSHUA GIETZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1151 N ADAIR ST, CORNELIUS, OR 97113-8900
(503) 359-5564
(503) 357-4371
Mailing address
PO BOX 6149, BEAVERTON, OR 97007-0149
(503) 352-8657
(503) 352-8658
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA184309
OR
Other
Enumeration date
05/26/2016
Last updated
11/07/2017
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