Provider Demographics
NPI:1851305791
Name:MCSTRAVICK, LESLIE WERSCHKUL (PA-C)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:WERSCHKUL
Last Name:MCSTRAVICK
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:743 COUNTRY CLUB RD
Mailing Address - Street 2:DERMATOLOGY
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6019
Mailing Address - Country:US
Mailing Address - Phone:541-681-5090
Mailing Address - Fax:541-683-5206
Practice Address - Street 1:743 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6019
Practice Address - Country:US
Practice Address - Phone:541-681-5090
Practice Address - Fax:541-683-5206
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORPA00974363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant