Individual
DR. JEFFREY S HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1000 SE UGLOW AVE, DALLAS, OR 97338-2645
(503) 623-8376
(503) 623-5293
Mailing address
1000 SE UGLOW AVE, DALLAS, OR 97338-2645
(503) 623-8376
(503) 623-5293
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO15134
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164780060
LOCATION NPI
OR
05
—
149096
—
OR
Enumeration date
02/08/2006
Last updated
01/18/2013
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