Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD204180 | OR |
N | 207XS0106X | Orthopaedic Hand Surgeon | MD204180 | OR |
NPI | 1184003881 |
---|---|
Provider Name | Jocelyn T Compton |
First Address | Portland, OR 97225-5933 |
Second Address | Portland, OR 97225-5933 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2015 |
Last Update Date | 10/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MD204180 | STATE LICENSE (01) | OR |