Individual
JOHN NICHOLAS JURGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16811 SE MCGILLIVRAY BLVD, VANCOUVER, WA 98683-3404
(360) 735-8100
(360) 253-1781
Mailing address
91302 N COBURG INDUSTRIAL WAY STE 122, COBURG, OR 97408-9331
(541) 500-6949
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA200542
OR
363A00000X
Physician Assistant
Primary
PA61240820
WA
Other
Enumeration date
04/01/2019
Last updated
09/13/2023
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