Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACOB HENDERSON, MD
Active Sole ProprietorJACOB HENDERSON, MD is a Pediatrics healthcare provider located in PORTLAND, Oregon. NPI 1598993628 is currently active in the NPPES registry. Verify at CMS.
Pediatrics · PORTLAND, OR
Registration Details
- NPI Number
- 1598993628
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 26, 2009 (17.150182517987 yrs)
- Last Updated
- Aug 19, 2016
- License
-
MD171504 (OR)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3181 SW SAM JACKSON PARK RDPORTLAND, OR, 972393011Browse OR providers · Browse ZIP 97239
- Phone
- 2536864246
- Primary Specialty
-
Pediatrics
208000000X
Other Pediatrics Providers in PORTLAND, OR
| Name | Credential | NPI |
|---|---|---|
| DAVID W PORTER | MD | 1811993058 |
| BRUCE J BIRK | M.D. | 1619973856 |
| JACK P SCHUNK | MD | 1063418325 |
| JAY S. ROSENBLOOM | M.D. | 1992701254 |
| MARI KAY EVANS-SMITH | MD | 1528064896 |
| ELIZABETH A CARR | M.D. | 1982600649 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.