Individual
NATHAN SPENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1311 E BARNETT RD STE 202, MEDFORD, OR 97504-8210
(541) 779-1041
(541) 779-8704
Mailing address
16083 SW UPPER BOONES FERRY RD STE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
OR 06843
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500678902
—
OR
01
—
P01554268 (CG5283)
RR MEDICARE
OR
Enumeration date
11/04/2014
Last updated
02/09/2016
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