Individual
JASON NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
5257 NE MARTIN LUTHER KING JR, SUITE 300, PORTLAND, OR 97211-3282
(503) 676-3710
Mailing address
5257 NE MARTIN LUTHER KING JR, SUITE 300, PORTLAND, OR 97211-3282
(503) 676-3710
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
16-CRM-007
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16-CRM-007
ACCBO
OR
Enumeration date
11/07/2016
Last updated
11/07/2016
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