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Individual

DR. PAUL GEORGE JENDRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
205 FERN VALLEY RD STE A, PHOENIX, OR 97535-9100
(541) 535-1274
(541) 535-6973
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(541) 535-1274
(541) 535-6973

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3854
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3854
STATE LICENSE #
AZ
Enumeration date
07/18/2005
Last updated
03/07/2023
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