Individual
DR. CODY BOYER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(503) 494-8211
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(503) 494-8211
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD223559
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2023
Last updated
04/11/2025
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