Ross, Jeremy Wade

Ross, Jeremy Wade is an individual health care provider with primary practice located at 965 Ellendale Dr , Medford OR 97504-8215. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Ross, Jeremy Wade can be contacted via phone (541) 732-6000.

Contact Information

Primary practice address
965 Ellendale Dr Medford OR 97504-8215
Phone: (541) 732-6000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA169124 Oregon

Profile Details

NPI number 1720496375
LBN Legal business name Ross, Jeremy Wade
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2014
Last updated Aug 20th, 2026 - about 2 months 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 1720496375 NPPES
Oregon MEDICAID 500674465

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