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Individual

DR. JEFFREY OWEN PENTECOST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3574 SE HAROLD CT, PORTLAND, OR 97202-4344
(503) 280-1621
Mailing address
3574 SE HAROLD CT, PORTLAND, OR 97202-4344

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
DO16894
OR

Other

Enumeration date
08/03/2011
Last updated
08/03/2011
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