Individual
MR. JASON FRANK KEPHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
827 SPRING ST, MEDFORD, OR 97504-6104
(541) 732-8360
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(541) 732-8360
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201405051NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500674715
—
OR
Enumeration date
04/27/2012
Last updated
03/18/2021
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