Individual
JOSHUA GLENN ANDREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
875 OAK ST SE, SUITE 5020, SALEM, OR 97301-3975
(503) 371-4044
(503) 371-4356
Mailing address
975 SE SANDY BLVD, SUITE 201, PORTLAND, OR 97214-1308
(503) 236-0775
(503) 236-0786
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA130000
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500612024
—
OR
Enumeration date
09/21/2009
Last updated
12/21/2021
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