Individual
JED J JUACHON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
100 WILLOW PLAZA, SUITE 301, PORTLAND, OR 93291-6215
(559) 734-3279
(559) 627-5723
Mailing address
5319 SW WESTGATE DR, SUITE 255, PORTLAND, OR 97221
(503) 445-2034
(503) 292-5885
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA18038
CA
Other
Enumeration date
06/15/2006
Last updated
07/08/2007
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