Individual
JEFFREY J HORACEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5050 NE HOYT ST, #203, PORTLAND, OR 97213-2991
(503) 230-9224
(503) 230-9201
Mailing address
5050 NE HOYT ST, #203, PORTLAND, OR 97213-2991
(503) 230-9224
(503) 230-9201
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD18532
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080114
—
OR
01
—
110164099
RR MEDICARE
OR
Enumeration date
06/22/2006
Last updated
09/14/2012
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