Individual
ANDREW J JASZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3838 PACIFIC AVE, FOREST GROVE, OR 97116-2224
(999) 999-9999
Mailing address
3838 PACIFIC AVE, FOREST GROVE, OR 97116-2224
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1068
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970024010
RAILROAD MEDICARE
IA
Enumeration date
06/04/2006
Last updated
03/21/2013
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