Overview
Name: JONATHAN REUEL VAN HORN PAC
Specialty: Surgical Physician Assistant
Type of Practice: Individual provider
Provider/Org:
Medical School: OTHER
Graduation year from medical school: 2002
Affiliation: LEGACY CLINICS LLC
Specialties
Practice Type: Physician Assistants & Advanced Practice Nursing Providers
Classification: Physician Assistant
Specialization: Surgical. PHYSICIAN ASSISTANT
Definition of Specialty: Definition to come…
License & NPI
License #(s): PA00833, PA10004741, PA00833, ,
License State(s): OR, WA, OR, ,
Addresses
Practice Location: 300 N GRAHAM ST STE 125,PORTLAND,OR,972271683,US
Mailing Address: PO BOX 3777,PORTLAND,OR,972083777,US
Contact #
Practice location phone #: 5034133714
Practice location fax #: 5034132061
Mailing address Phone #:
Mailing Address fax #:
Authorized official Name/Telephone #:
Misc
Date NPI was obtained: 08/24/2005
Last data data was updated: 11/19/2019
Insurances: