Jacob Watters

Physician Assistant · Roseburg, OR

Individual Active NPI

NPI number 1609480359

Practice location

2700 NW Stewart Pkwy
Roseburg, OR 97471-1281
Phone
(541) 673-0611

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NPI record

NPI
1609480359
Entity type
Individual (Type 1)
Enumeration date
September 1, 2020
Last updated
October 1, 2020
Certified
October 1, 2020
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X PA201167 OR

Mailing address

2971 Interstate Ave
Arco, ID 83213-8705
Phone
(801) 367-5004

About Jacob Watters

Jacob Watters is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 2700 NW Stewart Pkwy, Roseburg, OR 97471-1281. The NPI number 1609480359 was assigned on September 1, 2020 and the record was last updated on October 1, 2020.

Jacob Watters lists a license in the registry: #PA201167 (OR) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jacob Watters?

The NPI number is 1609480359.

What is the phone number of Jacob Watters?

The phone number listed for the practice location is (541) 673-0611.

Where is Jacob Watters located?

2700 NW Stewart Pkwy, Roseburg, OR 97471-1281.

What is the taxonomy code for Jacob Watters?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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