Individual
JONATHAN ERNESTO ALARCON-ANAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3512 LONE PINE RD, MEDFORD, OR 97504-5637
(541) 779-2003
(541) 772-0147
Mailing address
3512 LONE PINE RD, MEDFORD, OR 97504-5637
(541) 779-2003
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
A241902
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
323
DADS PROGRAM ON TRACK ROGUE VALLEY
OR
Enumeration date
11/05/2019
Last updated
11/05/2019
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