Thibeault, Justin Robert
Thibeault, Justin Robert is an individual health care provider with primary practice located at 1515 Nw 18Th Ave 3Rd Floor, Portland OR 97209-2516. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Thibeault, Justin Robert can be contacted via phone (503) 224-8399.Contact Information
Primary practice address
1515 Nw 18Th Ave 3Rd Floor
Portland OR 97209-2516
Phone: (503) 224-8399
Fax: (503) 224-5661
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA153476 | Oregon |
Profile Details
| NPI number | 1376579631 |
|---|---|
| LBN Legal business name | Thibeault, Justin Robert |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 25th, 2006 |
| Last updated | Jul 6th, 2016 - about 9 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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