Individual provider · Type 1 NPI
Jesse R. Shaffer, PA-C
Surgical Physician Assistant · Longview, WA
NPI number
1053647966
Active
Practice location
1615 Delaware St
Longview, WA 98632-2367
Fax (360) 501-3555
Mailing address
PO Box 3002
Longview, WA 98632-0302
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | PA60108805 (WA) |
Surgical Physician Assistant: Definition to come...
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About NPI 1053647966
Jesse R. Shaffer, PA-C's National Provider Identifier is 1053647966, issued on Oct 27, 2009. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Longview, WA. The record was last updated on Oct 27, 2009.