Individual
JAY C. P. JAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1130 NW 22ND AVE, SUITE 500, PORTLAND, OR 97210-2900
(503) 413-5725
(503) 413-5726
Mailing address
1130 NW 22ND AVE, SUITE 500, PORTLAND, OR 97210-2900
(503) 413-5725
(503) 413-5726
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD00047700
WA
208600000X
Surgery Physician
Primary
MD24533
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227380
—
OR
05
—
8376584
—
WA
Enumeration date
08/19/2005
Last updated
03/19/2013
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