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Individual

JEFFREY ROBERT MATHISEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2200 NE NEFF RD STE 302, BEND, OR 97701-4279
(541) 706-6915
(541) 706-6733
Mailing address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-2811

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD22909
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
287579
OR
05
8277055
WA
Enumeration date
07/19/2006
Last updated
08/30/2023
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