Individual
JACOB RILEY DEWEES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(034) 947-5515
(503) 494-4997
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(034) 947-5515
(503) 494-4997
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
95022172
CA
363LA2100X
Acute Care Nurse Practitioner
Primary
10003801
OR
Other
Enumeration date
08/10/2022
Last updated
03/27/2023
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