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1497998587
GARY A JACOBSEN
PORTLAND, OR
NPI
1497998587
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: OR MC08382)
Enumeration Date
2009-04-20
Last Update Date
2009-04-20
Business Address
-- GARY A JACOBSEN MD
6327 SW CAPITOL HWY. , SUITE C PMB 211
PORTLAND, OR 97239
Phone number: 503-245-1274
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Mailing Address
-- GARY A JACOBSEN MD
6327 SW CAPITOL HWY. , SUITE C PMB 211
PORTLAND, OR 97239
Phone number: 503-245-1274
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