Individual
MR. THOMAS JASON TRUBENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
F.N.P.
Contact information
Practice address
1311 E BARNETT RD, SUITE 201, MEDFORD, OR 97504-8225
(541) 779-5007
(541) 779-2055
Mailing address
1311 E BARNETT RD, SUITE 201, MEDFORD, OR 97504-8225
(541) 779-5007
(541) 779-2055
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
200040988RN
OR
363LF0000X
Family Nurse Practitioner
Primary
200550156NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
297670
—
OR
Enumeration date
07/28/2006
Last updated
11/13/2013
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