Individual
ALEXANDER NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1460 G ST, SPRINGFIELD, OR 97477-4112
(503) 689-5929
Mailing address
3574 DEER LAKE CT SE, SALEM, OR 97317-9378
(503) 689-5929
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA173144
OR
Other
Enumeration date
07/09/2015
Last updated
07/09/2015
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