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1215160510
KACEY L ANDREASEN
ONTARIO, OR
NPI
1215160510
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant, Medical
Additional Taxonomies
363AS0400X Physician Assistant, Surgical
Enumeration Date
2009-09-02
Last Update Date
2016-06-23
Business Address
Mr. KACEY L ANDREASEN PA-C
1050 SW 3RD AVE STE 1200
ONTARIO, OR 97914-4550
Phone number: 541-889-3111
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Mailing Address
Mr. KACEY L ANDREASEN PA-C
2523 SOUTH 10TH AVENUE #103
CALDWELL, ID 83605
Phone number: 208-459-7788
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