Individual
DR. JERROLD L SNOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6564 SE LAKE RD STE 200, MILWAUKIE, OR 97222
(503) 908-5880
(888) 475-8729
Mailing address
6564 SE LAKE RD STE 200, MILWAUKIE, OR 97222-2237
(503) 908-5880
(888) 475-8729
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D017285
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033840
—
OR
Enumeration date
09/20/2005
Last updated
06/22/2022
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