Individual
JANE JEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
940 SE CESAR E CHAVEZ BLVD, PORTLAND, OR 97214-4316
(503) 238-6053
Mailing address
14919 NW COSMOS ST, PORTLAND, OR 97229-6975
(310) 500-0981
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0016365
OR
183500000X
Pharmacist
71846
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0016365
STATE OF OREGON
OR
01
—
71846
STATE OF CALIFORNIA
CA
Enumeration date
11/04/2014
Last updated
01/05/2021
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