Provider Demographics
NPI:1295044394
Name:WESTERENG, OIVIND FREDERICK (PA-C)
Entity Type:Individual
Prefix:
First Name:OIVIND
Middle Name:FREDERICK
Last Name:WESTERENG
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3075 N RESERVE ST STE Q
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-1390
Mailing Address - Country:US
Mailing Address - Phone:406-327-1750
Mailing Address - Fax:406-327-1960
Practice Address - Street 1:3075 N RESERVE ST STE Q
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1390
Practice Address - Country:US
Practice Address - Phone:406-327-1750
Practice Address - Fax:406-327-1960
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT628363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant