Individual
JAYSON B HIETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1700 GEARY STREET SE, ALBANY, OR 97322-6842
(541) 812-5500
Mailing address
PO BOX 1188, CORVALLIS, OR 97339-1188
(541) 812-5500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA169971
OR
Other
Enumeration date
04/11/2013
Last updated
10/13/2021
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