Individual
JASON DAVIDSON ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
2073 OLYMPIC ST, SPRINGFIELD, OR 97477-3413
(541) 682-3550
(541) 682-3551
Mailing address
2073 OLYMPIC ST, SPRINGFIELD, OR 97477-3413
(541) 682-3550
(541) 682-3551
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201507389NP-PP
OR
Other
Enumeration date
10/24/2012
Last updated
10/29/2015
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