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Individual

JASON JOHN LINES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
9155 SW BARNES RD, SUITE 240, PORTLAND, OR 97225-6625
(503) 296-4027
(503) 216-2488
Mailing address
9155 SW BARNES RD, SUITE 240, PORTLAND, OR 97225-6625
(503) 296-4027
(503) 216-2488

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA00793
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8394264
WA
Enumeration date
02/22/2006
Last updated
10/24/2007
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