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Contact Information

ETHAN PACE
3011 E BARNETT RD
MEDFORD, OR97504
 Phone: 541-789-4673
 Fax: 541-789-2121
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Hematology & Oncology

207RH0003X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for ETHAN PACE · (Male)

NPI # 1508421751
Status Active
Credentials
Entity Individual
Enumeration date 05/02/2019
Last updated 01/17/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • OR License # PA197772
Hospital affiliation(s)
  • THREE RIVERS COMMUNITY HOSPITAL - (Acute Care)
    500 SW RAMSEY AVENUE
    GRANTS PASS, OR 97527
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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