Individual
MR. JURANDIR B DE MENEZES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3615 NW SAMARITAN DR, STE 201, CORVALLIS, OR 97330-3771
(541) 768-5930
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01048
OR
363AS0400X
Surgical Physician Assistant
PA60041664
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0253647
L&I
WA
Enumeration date
06/08/2006
Last updated
11/06/2020
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