Individual
JONATHAN PAUL OOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1233 EDGEWATER ST NW, SALEM, OR 97304-4049
(503) 378-7526
Mailing address
325 13TH ST NE STE 304, SALEM, OR 97301-2202
(706) 951-8625
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA216302
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/19/2023
Last updated
10/12/2023
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