DR. JERRY JEFF JABOIN (NPI# 1578610382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578610382 |
| Entity Type | Individual |
| Full Name | DR. JERRY JEFF JABOIN |
| Credential | MD |
| Practice Address |
3181 Sw Sam Jackson Park Rd # L337 Department of Radiation Medicine Portland OR 97239-3011 |
| Practice Telephone | 5034948756 |
| Mailing Telephone | 5034948756 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-10-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
MD174329 | OR | Allopathic & Osteopathic Physicians |
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
2010015937 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1578610382 | 05 | |
| MO | TRICARE | 431560263 | 01 |
| AR | 195048001 | 05 | |
| MO | RR MCR | P01128079 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1775 Thompson Rd, Coos Bay, OR 974202125 | 5412698111 |
| Street Address |
3181 SW SAM JACKSON PARK RD # L337 DEPARTMENT OF RADIATION MEDICINE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97239-3011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114304870 | Eric Michael Chang | Radiology | 3181 Sw Sam Jackson Park Rd # L337, Portland, OR 97239-3011 | 2015-05-01 |
| 1003235110 | Kiri Ann Cook | Radiology | 3181 Sw Sam Jackson Park Rd # L337, Portland, OR 97239 | 2014-04-16 |
| 1164775334 | Aaron Grossberg | Internal Medicine | 3181 Sw Sam Jackson Park Rd # L337, Portland, OR 97239 | 2012-10-24 |
| 1659662377 | Reid Frederick Thompson | Internal Medicine | 3181 Sw Sam Jackson Park Rd # L337, Portland, OR 97239-3011 | 2011-04-28 |
| 1396073706 | Ravi Anant Chandra | Radiology | 3181 Sw Sam Jackson Park Rd # L337, Portland, OR 97239-3098 | 2009-11-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558979468 | Elise Caitlin Esposito | Student in an Organized Health Care Education/Training Program | 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 | 2020-07-16 |
| 1750908844 | Will Cowan | Student in an Organized Health Care Education/Training Program | 455 Sw Us Veterans Hospital Road., Portland, OR 97239 | 2020-07-06 |
| 1881219657 | Desiree Baer | Licensed Vocational Nurse | Sw Us Veterans Hospital Rd, Portland, OR 97239 | 2020-06-08 |
| 1285266205 | Melissa Irene Wheeler | Registered Nurse | Uhs-8l, 3181 S.w. Sam Jackson Park Road, Portland, OR 97239 | 2020-02-07 |
| 1225687981 | Pheba Mariam Jones | Pharmacist | Ohsu Pharmacy At Chh Building 2, 3303 Sw Bond Ave Rm 1090, Portland, OR 97239 | 2019-09-05 |
| 1801448063 | Alice Huang Huang | Student in an Organized Health Care Education/Training Program | 3710 Sw Veterans Road, Portland, OR 97239 | 2019-07-09 |
| 1710446273 | Ellen Noreen Kessi | Social Worker | 3710 Sw Us Veterans Rd., Portland, OR 97239 | 2019-03-14 |
| 1508335704 | Jacqueline Marie Mular | Marriage & Family Therapist | 5550 Sw Macadam Suite 100, Portland, OR 97239 | 2018-11-16 |
| 1275030926 | Carly Elizabeth Dougher | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd., Portland, OR 97239 | 2018-04-10 |
| 1780188094 | Dennis John Samuel | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239 | 2018-03-21 |
| Find all providers in zip 97239 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235549031 | Amar Srivastava | Radiology | 4805 Ne Glisan St, Garden Level, Portland, OR 97213 | 2014-05-01 |
| 1962848655 | Joshua M Walker | Radiology | 3181 Sw Sam Jackson Park Rd # Kpv4, Portland, OR 97239 | 2013-05-21 |
| 1770520892 | Katie Anne Deming | Radiology | 1400 Nw Irving St, 527, Portland, OR 97209-2210 | 2006-05-31 |
| 1043299217 | Andrew Yoo Jong Kee | Radiology | 1130 Nw 22nd Ave Ste Ll50, Portland, OR 97210-2900 | 2006-01-16 |
| 1083601835 | Thomas Harry Johnson | Radiology | 3620 N Interstate Ave, Portland, OR 97227-1106 | 2005-10-05 |
| 1356338149 | Misa Melissa Lee | Radiology | 1130 Nw 22nd Avenue, Ll50, Portland, OR 97210-2900 | 2005-10-05 |
| 1952780512 | Blair M Murphy | Radiology | 3181 Sw Sam Jackson Park Rd # Kpv4, Portland, OR 97239-3011 | 2015-05-28 |
| 1114304870 | Eric Michael Chang | Radiology | 3181 Sw Sam Jackson Park Rd # L337, Portland, OR 97239-3011 | 2015-05-01 |
| 1073908505 | Whitney Beeler | Radiology | 22 Bramhall St, Portland, ME 04102-3134 | 2015-04-01 |
| 1831509926 | William Tristram Arscott | Radiology | 265 N Broadway, Portland, OR 97227-1800 | 2014-04-29 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.