THERON J WIESE


Address: 1395 Commercial St Se, Salem, OR 97302-4205
Phone: 5039907187

THERON J WIESE (NPI# 1841648862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1841648862
Entity Type Individual
Full Name THERON J WIESE
Credential PA-C
Practice Address 1395 Commercial St Se
Salem
OR 97302-4205
Mailing Address 6108 Sw 18th Dr Apt 9
Portland
OR 97239-1951
Practice Telephone 5039907187
Mailing Telephone 9713449996
Enumeration Date 2016-05-31
Last Update Date 2017-10-24
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
PA184738 OR Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1395 COMMERCIAL ST SE
City SALEM
State OR
Zip Code 97302-4205

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1952954679 Eric Anthony Bohm Pharmacist 2757 22nd St. Se, Salem, OR 97302 2019-07-22
1598223737 Michael Robert Martini Counselor 960 Liberty Rd Se Suite 120, Salem, OR 97302 2019-03-06
1659857480 Avalina Pharmacy Inc Pharmacy 3507 Commercial St Se, Salem, OR 97302 2018-07-16
1649762733 Joseph Bochsler Physical Therapist 3220 Liberty Rd. S., Salem, OR 97302 2018-06-04
1922533652 Brianne Elizabeth Sischo Licensed Practical Nurse 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 2017-05-01
1851825566 Modern Nose Clinic LLC Otolaryngology 340 Vista Ave Se, Ste 100, Salem, OR 97302 2017-04-19
1720529803 Nicholas Forsberg Massage Therapist 126 Mize Rd S, Salem, OR 97302 2017-03-09
1437691078 Kimo Mahi Specialist/Technologist, Other 2373 Kuebler Rd. S, Salem, OR 97302 2016-11-14
1588113278 New Life Family Medicine LLC Clinic/Center 842 Commercial Street Ne, Salem, OR 97302 2016-09-23
1073060117 Susan Morag Robnett Counselor 912 Fir Street South, Salem, OR 97302 2016-09-07
Find all providers in zip 97302

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1285255851 Darby Samantha Jalbert Physician Assistant 2480 Liberty St Ne Ste 110, Salem, OR 97301-8381 2020-05-05
1639614852 Gregory Bull Physician Assistant 622 Fernwood Dr, Salem, VA 24153-2654 2016-12-24
1922329697 Charleen Ann Thorburn Physician Assistant 22 Keewaydin Dr, Salem, NH 03079-2839 2010-06-17
1316188006 Judith A Mitchell Physician Assistant 4999 Skyline Rd. S., Salem, OR 97306 2009-03-10
1215912712 Amy Gouley Physician Assistant 1793 13th St Se, Salem, OR 97302-2541 2005-12-07
1306827100 William Earle Williams Physician Assistant 1233 Edgewater St Nw, Salem, OR 97304-4049 2005-11-08
1700485224 Roderick Mao Physician Assistant 159 N Broadway, Salem, NH 03079-2136 2020-10-26
1447719752 Christine Nicole Jeffries Physician Assistant 360 Church St Se, Salem, OR 97301-3796 2019-03-16
1265999338 Brolin Johnson Physician Assistant 1793 13th St Se, Salem, OR 97302-2541 2019-02-26
1073088191 Fiorella Saavedra Physician Assistant 255 Lancaster Dr Ne, Salem, OR 97301-5155 2018-10-04
Find all providers in SALEM

Competitor

Search similar providers

City SALEM
Zip Code 97302

Improve Information

Please comment or provide details below to improve the information on THERON J WIESE.

Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

Trending Searches