Individual
JILLIAN NICOLE SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK ROAD, OHSU, PORTLAND, OR 97239
(503) 494-8211
Mailing address
3181 SW SAM JACKSON PARK ROAD, CR-139, PORTLAND, OR 97239-3011
(503) 494-6066
Taxonomy
Speciality
Code
Description
License number
State
2080S0012X
Pediatric Sleep Medicine Physician
Primary
MD176578
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2013
Last updated
07/07/2017
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