Individual
JONATHAN MASON ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1225 NE 2ND AVE, PORTLAND, OR 97232-2003
(503) 944-8000
Mailing address
PO BOX 4399, PORTLAND, OR 97208-4399
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
A179842
CA
2084P0800X
Psychiatry Physician
Primary
MD220208
OR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/23/2020
Last updated
01/07/2025
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