Individual
JEREMIAH BEN KNAPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10803 SE CHERRY BLOSSOM DRIVE, PORTLAND, OR 97216-3107
(503) 261-7200
(503) 261-7249
Mailing address
10803 SE CHERRY BLOSSOM DRIVE, PORTLAND, OR 97216-3107
(503) 261-7200
(503) 261-7249
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD-21779
HI
207Q00000X
Family Medicine Physician
Primary
MD218059
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500833592
—
OR
01
—
MD218059
OREGON MEDICAL BOARD LICENSE
OR
Enumeration date
07/01/2014
Last updated
05/22/2024
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