Individual
JODI HANAUSKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3355 RIVERBEND DR, SUITE 400, SPRINGFIELD, OR 97477-8800
(541) 686-8353
(541) 681-3078
Mailing address
3355 RIVERBEND DR, SUITE 400, SPRINGFIELD, OR 97477-8800
(541) 686-8353
(541) 681-3078
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
00714
OR
Other
Enumeration date
07/28/2005
Last updated
11/07/2019
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