Individual
JESSE M POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5050 NE HOYT ST, SUITE 540, PORTLAND, OR 97213-2991
(503) 215-6600
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD169572
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500666193
—
OR
Enumeration date
05/02/2012
Last updated
07/16/2015
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