Individual
JACOB ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 273-5049
Mailing address
PO BOX 19112, PORTLAND, OR 97280-0112
(616) 240-8794
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
10047225
OR
Other
Enumeration date
07/17/2025
Last updated
07/17/2025
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