Individual
DR. JASON CHRISTOPHER KROENING-ROCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.P.H.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8211
Mailing address
2209 SE 47TH AVE, PORTLAND, OR 97215-3805
(503) 702-4363
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD167038
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD167038
STATE MEDICAL LICENSE
OR
Enumeration date
04/01/2012
Last updated
05/11/2015
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