Individual
JACOB ANDERSON REISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3325 N INTERSTATE AVE, PORTLAND, OR 97227-1022
(503) 331-6596
(503) 331-6320
Mailing address
3325 N INTERSTATE AVE, KAISER PERMANENTE INTERSTATE MEDICAL OFFICE WEST, PORTLAND, OR 97227-1020
(503) 813-2000
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
G21401
CA
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
OR MD08690
OR
207SG0201X
Clinical Genetics (M.D.) Physician
WA MD00013839
WA
Other
Enumeration date
10/03/2006
Last updated
07/16/2007
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