Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 207P00000X | CO |
Y | 207P00000X | Emergency Physician | MD182845 | OR |
NPI | 1013274570 |
---|---|
Provider Name | Dr. Jessica Slim |
First Address | Portland, OR 97239-3011 |
Second Address | Portland, OR 97239-3011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2012 |
Last Update Date | 17/03/2018 |