Individual
DR. JACK A. ROSENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
5920 N. E. RAY CIRCLE, SUITE 220, HILLSBORO, OR 97124-6313
(503) 690-0707
(503) 690-9796
Mailing address
5920 N.E. RAY CIRCLE, SUITE 220, HILLSBORO, OR 97124-6313
(503) 690-0707
(503) 690-9796
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD08402
OR
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD08402
OR
2080P0202X
Pediatric Cardiology Physician
MD08402
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164012
—
OR
Enumeration date
04/11/2006
Last updated
04/28/2017
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