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Individual

EMILY JACOBSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
3930 SE DIVISION ST, PORTLAND, OR 97202-1643
(503) 418-3900
Mailing address
3930 SE DIVISION ST, PORTLAND, OR 97202-1643

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA00997
OR
363AM0700X
Medical Physician Assistant
Primary

Other

Enumeration date
08/03/2006
Last updated
12/29/2020
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