Individual
JERRY EVERETT KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 652-2880
Mailing address
10230 E ARROWVALE DR, SUN LAKES, AZ 85248-7649
(480) 802-1259
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
30952
AZ
2085R0202X
Diagnostic Radiology Physician
MD00034639
WA
2085R0202X
Diagnostic Radiology Physician
Primary
MD08996
OR
Other
Enumeration date
02/19/2007
Last updated
07/08/2007
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