Van Horn, Jonathan Reuel

Van Horn, Jonathan Reuel is an individual health care provider with primary practice located at 300 N Graham St Ste 125 , Portland OR 97227-1683. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Van Horn, Jonathan Reuel can be contacted via phone (503) 413-3714.

Contact Information

Primary practice address
300 N Graham St Ste 125 Portland OR 97227-1683
Phone: (503) 413-3714
Fax: (503) 413-2061
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA00833 Oregon
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA10004741 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA00833 Oregon

Profile Details

NPI number 1992798060
LBN Legal business name Van Horn, Jonathan Reuel
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2005
Last updated Nov 19th, 2019 - about 7 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 1992798060 NPPES
Oregon MEDICAID 500600859

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