Individual
DR. MARK STEPHEN JARDINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4015 MERCANTILE DR, SUITE 200, LAKE OSWEGO, OR 97035-2552
(503) 216-1500
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD15995
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
087460
—
OR
Enumeration date
08/30/2006
Last updated
01/28/2014
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