Individual
JOY ELIZABETH LIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
500 NE A ST STE 100, MADRAS, OR 97741-1842
(541) 383-3005
(541) 383-1883
Mailing address
600 SW COLUMBIA ST, SUITE 6210, BEND, OR 97702-1099
(541) 383-3005
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA179809
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500715727
—
OR
Enumeration date
05/14/2015
Last updated
01/11/2023
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