Individual
EMILY JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
130 THOMPSON ST, HEPPNER, OR 97836-7325
(541) 676-5504
(541) 676-8247
Mailing address
PO BOX 9, HEPPNER, OR 97836-0009
(541) 676-5504
(541) 676-8247
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD211954
OR
Other
Enumeration date
05/01/2019
Last updated
12/02/2025
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