Individual
JOHN G STANKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
702 SW RAMSEY AVE STE 112, GRANTS PASS, OR 97527-5859
(541) 472-0603
(541) 472-0609
Mailing address
702 SW RAMSEY AVE STE 112, GRANTS PASS, OR 97527-5859
(541) 472-0603
(541) 472-0609
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500630894
—
OR
Enumeration date
02/08/2008
Last updated
02/11/2019
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