Individual
JAKE WALKER SHARP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2925 RYAN DR SE, SALEM, OR 97301-9687
(503) 399-1262
(503) 371-0777
Mailing address
2925 RYAN DR SE, SALEM, OR 97301-9687
(503) 399-1262
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD202293
OR
2085R0202X
Diagnostic Radiology Physician
MD60876778
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720465933
—
WA
05
—
500789539
—
OR
Enumeration date
04/27/2015
Last updated
01/31/2024
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