Individual
JACLYN BONDHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1021 NE 6TH ST, GRANTS PASS, OR 97526-1113
(541) 507-1881
Mailing address
3503 CARNELIAN ST, MEDFORD, OR 97504-4224
(720) 560-3152
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA187102
OR
Other
Enumeration date
03/12/2018
Last updated
06/07/2022
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