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Theron J Wiese, PA-C
Medical Physician Assistant in Salem, Oregon
NPI 1841648862

Theron J Wiese is a Medical Physician Assistant based in Portland, OR and is specialized in Medical. Theron J Wiese practices in Salem, OR and has the professional credentials of PA-C. The NPI Number for Theron J Wiese is 1841648862 and holds a License No. PA184738 (Oregon).

The current practice location address for Theron J Wiese is 1395 Commercial St Se, Salem, OR and can be reached out via phone at 503-990-7187.

Location: 1395 Commercial St Se, Salem, OR, 97239-1951
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Provider Profile Details
NPI Number
1841648862
Provider Name
Theron J Wiese
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
1395 Commercial St Se, Salem, OR, 97239-1951
Phone Number
503-990-7187
Fax Number
Provider Enumeration Date
05/31/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1395 Commercial St Se
City
State
Zip
97302-4205
Phone Number
503-990-7187
Fax Number
person
Provider Business Mailing Address Details
Address
1395 Commercial St Se
City
State
Zip
97302-4205
Phone Number
503-990-7187
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA184738 (Oregon)
Definition
Definition to come...
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