Individual
JONATHAN ROSEN SOFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8562
(503) 418-5505
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8562
(503) 418-5505
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
201150147NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218105
—
OR
Enumeration date
10/12/2011
Last updated
05/24/2021
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