Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | L-240991 | MA |
N | 111NI0900X | Internist | L-240991 | MA |
N | 207RC0000X | Internist - Cardiovascular Disease | 126853 | OH |
N | 207RC0000X | Internist - Cardiovascular Disease | MD181462 | OR |
Y | 207RI0011X | Interventional Cardiology | MD181462 | OR |
NPI | 1043447873 |
---|---|
Provider Name | Brandon M Jones |
First Address | Portland, OR 97208-3158 |
Second Address | Portland, OR 97225-6612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2009 |
Last Update Date | 15/02/2021 |