Individual
MR. JACOB ANDRE MCLAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3736 SE CORA ST, PORTLAND, OR 97202-3238
(503) 756-7070
Mailing address
3736 SE CORA ST, PORTLAND, OR 97202-3238
(503) 756-7070
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
201394848CRNA
OR
Other
Enumeration date
12/10/2011
Last updated
01/24/2014
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