Individual
JIYEON JEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
727 S WAHANNA RD, SEASIDE, OR 97138-7735
(503) 717-7060
Mailing address
PO BOX 3397, PORTLAND, OR 97208-3397
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036142569
IL
207Q00000X
Family Medicine Physician
Primary
MD190569
OR
Other
Enumeration date
03/26/2014
Last updated
09/28/2020
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