Individual
JACOB GEYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-2200
Mailing address
14905 SW 106TH AVE, TIGARD, OR 97224-4754
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA217971
OR
363A00000X
Physician Assistant
—
—
Other
Enumeration date
03/10/2023
Last updated
11/06/2023
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