Damon C Stout PA-S

NPI 1629210612 - Physician Assistant - 363A00000X

NPI Details
NPI 1629210612
Gender Male
Enumeration Date 04/06/2009
Last Updated 01/20/2011
Entity Type Individual
Active Over 7 years ago
Practice Location
1600 STATE ST
SALEM OR, 97301-4257, US
Phone (503) 540-6300
Fax
Business Location
1600 STATE ST
SALEM OR, 97301-4257, US
Phone (503) 540-6300
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Oregon
License Number PA152945
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According to our database, Damon C Stout PA-S NPI is 1629210612, taxonomy code is 363A00000X and license number is PA152945, license state is located at Oregon. Damon C Stout PA-S physically located at 1600 State St, Salem OR, 97301-4257. NPI Number Damon C Stout PA-S has the Individual type.

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1629210612 NPI number is provided on an as is basis without warranty of any kind. 1629210612 is maintained by the National Plan & Provider Enumeration System. The contents of Damon C Stout PA-S are for informational purposes only.