Provider Demographics
NPI:1013311497
Name:HORST, JOEL (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:
Last Name:HORST
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19255 SW 65TH AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-9712
Mailing Address - Country:US
Mailing Address - Phone:503-828-1150
Mailing Address - Fax:503-828-1160
Practice Address - Street 1:5125 SKYLINE RD S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97306-9427
Practice Address - Country:US
Practice Address - Phone:503-763-3639
Practice Address - Fax:503-315-4678
Is Sole Proprietor?:No
Enumeration Date:2014-10-14
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORPA169939363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical