Individual
JILL R. HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12121 E BURNSIDE ST, PORTLAND, OR 97216-3737
(971) 361-7700
(503) 274-4815
Mailing address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD23299
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
240276
—
OR
05
—
8484156
—
WA
Enumeration date
10/02/2006
Last updated
11/21/2024
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