# JAY PAUL DOUGLASS MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578849360
- **Authorized official:** JAY PAUL DOUGLASS MD (MEMBER)
- **Authorized official phone:** (503) 635-6256

## Contact information

- **Practice address:** 6464 SW BORLAND RD STE C1, TUALATIN, OR 97062-8856
- **Practice address phone:** (503) 635-6256
- **Practice address fax:** (503) 636-9604
- **Mailing address:** 6464 SW BORLAND RD STE C1, TUALATIN, OR 97062-8856
- **Mailing address phone:** (503) 635-6256
- **Mailing address fax:** (503) 636-9604

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | MD153785 | OR | Yes |

## Other

- **Enumeration date:** 10/25/2011
- **Last updated:** 07/15/2024