James Francis Deitle, PA-C
Physician Assistant in Portland, OR. Individual provider (NPI-1).
NPI number1003000753
StatusActive
Last updated in NPPESJan 22, 2011
Details
- NPI
- 1003000753
- Entity type
- Individual (NPI-1)
- Name
- James Francis Deitle
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 5, 2007
- Last updated
- Jan 22, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 153509 | OR | Yes |
| 363A00000X | Physician Assistant | 664 | AK |
Practice location
501 N Graham StSuite #580
Portland, OR 97227-1654
Phone 503-528-0704 · Fax 503-528-0708
Mailing address
501 N Graham StSuite #580
Portland, OR 97227-1654
Phone 503-528-0704 · Fax 503-528-0708
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