IndividualActive
Jeffrey Komisarof, MD
NPI 1043318405 · Nephrology Physician · Portland, OR
Provider details
- NPI number
- 1043318405
- Entity type
- Individual
- Primary specialty
- Nephrology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- MD26611 (OR)
Practice location
10201 Se Main St
Suite 27
Portland, OR 97216-2937
Phone: (503) 256-0877
Fax: (503) 256-4188
Mailing address
10201 Se Main St
Portland, OR 97216-2937
Registry dates
- Enumerated
- 2006-09-20
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.