Individual
MARC ALLAN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 NE 99TH AVE STE 200, PORTLAND, OR 97220-9442
(503) 963-3030
(503) 963-3140
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD21664
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139413
—
OR
05
—
8485407
—
WA
Enumeration date
08/24/2006
Last updated
11/21/2023
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