Individual
CLEM V POPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
47815 HIGHWAY 58, OAKRIDGE, OR 97463-9572
(541) 782-8304
Mailing address
PO BOX 546, GRESHAM, OR 97030-0132
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA200928
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500786854
—
OR
Enumeration date
05/01/2019
Last updated
08/23/2022
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