Provider Demographics
NPI:1144393133
Name:PAREDES, ELMER (RPA-C)
Entity type:Individual
Prefix:MR
First Name:ELMER
Middle Name:
Last Name:PAREDES
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7730 171ST ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1407
Mailing Address - Country:US
Mailing Address - Phone:718-969-1949
Mailing Address - Fax:
Practice Address - Street 1:355 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:OR
Practice Address - Zip Code:97448-1313
Practice Address - Country:US
Practice Address - Phone:541-640-7625
Practice Address - Fax:541-644-3477
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA171617363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant