Individual
JORDAN MICHAEL PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(503) 216-1234
Mailing address
2121 NW RALEIGH ST APT 130, PORTLAND, OR 97210-2148
(503) 869-3609
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD223168
OR
Other
Enumeration date
03/31/2021
Last updated
08/05/2025
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