Individual
NICHOLAS BOYD JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3101 SW SAM JACKSON PARK ROAD, PORTLAND, OR 97239-3009
(503) 221-3424
(503) 221-3490
Mailing address
PO BOX 8500, LOCKBOX 7642, SHRINERS HOSPITALS FOR CHILDREN, PORTLAND, PHILADELPHIA, PA 19178-7642
(813) 281-8115
(813) 281-8656
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
OR
Other
Enumeration date
07/06/2018
Last updated
09/05/2018
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