Individual
JEFFREY DONOVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, L586, PORTLAND, OR 97239-3011
(541) 285-7427
Mailing address
3181 SW SAM JACKSON PARK RD, L586, PORTLAND, OR 97239-3011
(541) 285-7427
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA179246
OR
Other
Enumeration date
09/06/2016
Last updated
09/06/2016
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