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

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XPA60108805 (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.