Individual
MR. JEFFREY DUANE SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
11711 NE GLISAN ST, PORTLAND, OR 97220-2141
(503) 256-1557
Mailing address
7704 SE 110TH AVE, PORTLAND, OR 97266-8001
(503) 762-8281
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6897
OR
Other
Enumeration date
05/06/2006
Last updated
07/08/2007
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