Individual
LAWRENCE EDWARD JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7641
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7641
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD20522
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD20522
LICENSE
OR
Enumeration date
07/28/2006
Last updated
06/08/2016
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