Individual
DR. PETER JACKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, FACMG
Contact information
Practice address
13705 NE AIRPORT WAY, SUITE C, PORTLAND, OR 97230-1048
(503) 258-6721
(503) 258-6732
Mailing address
4710 NW BARNES RD, PORTLAND, OR 97210-1012
(503) 223-8985
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
—
—
246ZG1000X
Medical Geneticist (PhD) Specialist/Technologist
Primary
—
—
Other
Enumeration date
08/18/2006
Last updated
09/11/2025
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