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1609480359
JACOB WATTERS
ROSEBURG, OR
NPI
1609480359
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: OR PA201167)
Enumeration Date
2020-09-01
Last Update Date
2020-10-01
Business Address
JACOB WATTERS
2700 NW STEWART PKWY
ROSEBURG, OR 97471-1281
Phone number: 541-673-0611
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Mailing Address
JACOB WATTERS
2971 INTERSTATE AVE
ARCO, ID 83213-8705
Phone number: 801-367-5004
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