Individual
JORDON GABRIEL DEROWITSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1600 STATE ST, SALEM, OR 97301-4257
(971) 218-3402
Mailing address
1755 RESERVE LN S APT 229, SALEM, OR 97306-3007
(971) 218-3402
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
223362
OR
363AS0400X
Surgical Physician Assistant
Primary
PA223362
OR
Other
Enumeration date
12/09/2024
Last updated
08/20/2025
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