Organization
JERROLD L SNOW LLC
Active
Other names
Woodstock Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERROLD L SNOW D.O. (PHYSICIAN)
(503) 236-1830
Entity
Organization
Contact information
Practice address
5536 SE WOODSTOCK BLVD, PORTLAND, OR 97206-6829
(503) 236-1830
(503) 236-1908
Mailing address
5536 SE WOODSTOCK BLVD, PORTLAND, OR 97206-6829
(503) 236-1830
(503) 236-1908
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D017285
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033840
—
OR
Enumeration date
02/12/2008
Last updated
09/25/2008
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