Provider Demographics
NPI:1740797166
Name:SOMETHING, JOSEPH (PA-C)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:SOMETHING
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 SW 76TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-1804
Mailing Address - Country:US
Mailing Address - Phone:971-808-0665
Mailing Address - Fax:971-808-0647
Practice Address - Street 1:4800 SW 76TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-1804
Practice Address - Country:US
Practice Address - Phone:971-808-0665
Practice Address - Fax:971-808-0647
Is Sole Proprietor?:No
Enumeration Date:2018-01-08
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical