Individual
JOHN MEJASIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
113 N ELM ST, CANBY, OR 97013-3519
(503) 263-8903
(503) 266-8632
Mailing address
113 N ELM ST, CANBY, OR 97013-3519
(503) 263-8903
(503) 266-8632
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
341015
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500768980
—
OR
Enumeration date
06/16/2015
Last updated
10/07/2019
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