Individual
STEPHANIE DE JESUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10315 NE TANASBOURNE DR, HILLSBORO, OR 97124-7836
(800) 813-2000
Mailing address
500 NE MULTNOMAH ST FL 11, PORTLAND, OR 97232-2023
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1724301
NY
207R00000X
Internal Medicine Physician
Primary
MD207662
OR
207R00000X
Internal Medicine Physician
TEXASRULE172.20
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01169818
—
NY
01
—
1144361163
MEDICARE NPI ORGANIZATION
NY
Enumeration date
08/31/2005
Last updated
11/05/2025
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