Most Relevant Information
Provider Data
| NPI Number: | 1003340613 |
| Provider Name: | ALEJANDRO ELLIOTT COLMENERO MSPA, PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/20/2017 |
| Last Updated: | 06/02/2021 |
Provider Practice Location
21 HAYDEN BRIDGE WAY
SPRINGFIELD
OR
974771305
Practice Location Phone/Fax
| Phone: | 5417474300 |
| Fax: | 5417470655 |
Provider Mailing Location
2280 MARCOLA RD
SPRINGFIELD
OR
974772594
Provider Mailing Phone/Fax
| Phone: | 5417474300 |
| Fax: | 5417470655 |