Individual
MR. TREBOR TAYLOR STRUBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA10005236
WA
363AS0400X
Surgical Physician Assistant
Primary
PA01425
OR
Other
Enumeration date
11/07/2007
Last updated
12/29/2008
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