Individual
MR. JONATHAN EDWARD NORDHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
625 SW RAMSEY AVE, GRANTS PASS, OR 97527-5808
(541) 507-2290
(541) 507-2291
Mailing address
625 SW RAMSEY AVE, GRANTS PASS, OR 97527-5808
(541) 507-2290
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0075241
NY
363A00000X
Physician Assistant
Primary
179767
OR
Other
Enumeration date
03/26/2007
Last updated
03/28/2018
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