Individual provider · Type 1 NPI

Justin Scott Fuller, PA

Student in an Organized Health Care Education/Training Program · Madras, OR

NPI number 1609767227 Active

Practice location

470 NE A St
Madras, OR 97741-1844

Call (541) 475-4800 Map

Fax (541) 475-4805

Mailing address

4311 11th Ave NE Ste 200
Seattle, WA 98105-6367

Other practice locations

  • 4311 11th Ave NE Ste 200, Seattle, WA 98105-6367 · (206) 616-4001

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1609767227

Justin Scott Fuller, PA's National Provider Identifier is 1609767227, issued on Jul 11, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Madras, OR. The record was last updated on Apr 16, 2026.