Individual
JACOB SIEGBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
10763 SW GREENBURG RD STE 100, TIGARD, OR 97223-5492
(503) 684-8159
Mailing address
10763 SW GREENBURG RD STE 100, TIGARD, OR 97223-5492
(503) 684-8159
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201330195LPN
OR
Other
Enumeration date
05/20/2016
Last updated
05/20/2016
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