Ross, Jacob

Ross, Jacob is an individual health care provider with primary practice located at 1600 Delta Waters Rd Ste 107 , Medford OR 97504-9114. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Ross, Jacob can be contacted via phone (541) 858-2515.

Contact Information

Primary practice address
1600 Delta Waters Rd Ste 107 Medford OR 97504-9114
Phone: (541) 858-2515
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 1 Utah
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 10031846 Oregon

Profile Details

NPI number 1770355851
LBN Legal business name Ross, Jacob
Credentials FNP- C
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2023
Last updated Oct 23rd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770355851 NPPES
Oregon Other 10031846 OREGON NURSING LICENSE
Oregon MEDICAID 500841831 OREGON NURSING LICENSE

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