Individual
JEFFREY PENIKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9427 SW BARNES RD, SUITE 395, PORTLAND, OR 97225-6652
(503) 216-2602
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
98132
NM
207V00000X
Obstetrics & Gynecology Physician
Primary
MD28585
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024176
—
OR
05
—
R6665
—
NM
Enumeration date
07/11/2006
Last updated
10/02/2020
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