Individual
DR. JORDAN ROBERT YOUNG CARUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(503) 494-8211
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(503) 494-8211
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD204398
OR
207P00000X
Emergency Medicine Physician
PG201350
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2018
Last updated
06/14/2021
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