Organization
JESSICA G ROBERTS, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA ROBERTS MD (OWNER)
(503) 319-4966
Entity
Organization
Contact information
Practice address
4805 NE GLISAN ST, PORTLAND, OR 97213-2933
(503) 319-4966
Mailing address
3439 NE SANDY BLVD, PMB 375, PORTLAND, OR 97232-1959
(503) 284-8841
(503) 282-3302
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD23993
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286343
—
OR
Enumeration date
10/11/2006
Last updated
08/22/2020
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