Provider Demographics
NPI:1679594089
Name:RUBIN, DANA KATHRYN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:KATHRYN
Last Name:RUBIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:DANA
Other - Middle Name:KATHRYN
Other - Last Name:GOLDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:74B CENTENNIAL LOOP STE 100
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7919
Mailing Address - Country:US
Mailing Address - Phone:541-284-0530
Mailing Address - Fax:541-284-0529
Practice Address - Street 1:74B CENTENNIAL LOOP STE 100
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7919
Practice Address - Country:US
Practice Address - Phone:541-284-0530
Practice Address - Fax:541-284-0529
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA00420363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical