Individual
JASON TALBOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
211 NE 18TH AVE, PORTLAND, OR 97232-2822
(971) 248-8899
Mailing address
12290 SW MARION ST, TIGARD, OR 97223-2962
(609) 751-1348
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
112694
OR
Other
Enumeration date
01/06/2025
Last updated
07/02/2025
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