Provider Demographics
NPI:1710685417
Name:RAFUS, MATTHEW JORDAN (PA)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JORDAN
Last Name:RAFUS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1189
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97339-1189
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3620 NW SAMARITAN DR STE 202
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-3785
Practice Address - Country:US
Practice Address - Phone:541-768-4810
Practice Address - Fax:541-768-4813
Is Sole Proprietor?:No
Enumeration Date:2023-02-21
Last Update Date:2023-04-17
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant