Individual
PATRICK S BASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
3311 RIVERBEND DR FL 3, SPRINGFIELD, OR 97477-8800
(541) 484-4332
(541) 242-6770
Mailing address
1115 SE 164TH AVE DEPT 358, VANCOUVER, WA 98683-8004
(360) 729-1253
(360) 729-3185
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5746
FL
363A00000X
Physician Assistant
Primary
PA195563
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U6611Y
RAILROAD MEDICARE
FL
Enumeration date
08/19/2006
Last updated
01/26/2021
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