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Individual

MS. NANCY JANETTE MEZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
13000 SW 2ND ST, BEAVERTON, OR 97005-2615
(503) 259-5045
Mailing address
PO BOX 568, CORNELIUS, OR 97113-0568
(503) 352-8657
(503) 352-8658

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA170564
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500685435
OR
Enumeration date
03/25/2013
Last updated
09/07/2016
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