Most Relevant Information
Provider Data
| NPI Number: | 1003262635 |
| Provider Name: | PAUL EMERSON JAQUES DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 61646 |
Most Important Dates
| Enumeration Date: | 05/12/2016 |
| Last Updated: | 05/12/2016 |
Provider Practice Location
2350 NW CENTURY DR
CORVALLIS
OR
973303495
Practice Location Phone/Fax
| Phone: | 5417541265 |
| Fax: |
Provider Mailing Location
444 NW ELKS DR
CORVALLIS
OR
973303745
Provider Mailing Phone/Fax
| Phone: | 5417541150 |
| Fax: |