Individual
JEFF ALLEN CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4805 NE GLISAN ST, SUITE BG05, PORTLAND, OR 97213-2933
(503) 215-2392
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LL16983
OR
207R00000X
Internal Medicine Physician
MD151002
OR
208M00000X
Hospitalist Physician
Primary
MD151002
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500624540
—
OR
01
—
P00848608
RR MEDICARE - PHS
OR
Enumeration date
08/06/2007
Last updated
03/30/2017
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