IndividualActive
Jack Simon, M.D.,PH.D.
NPI 1083786024 · Neuroradiology Physician · Portland, OR
Provider details
- NPI number
- 1083786024
- Entity type
- Individual
- Primary specialty
- Neuroradiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.,PH.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 23522 (CO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
3710 Sw Veterans Hospital Rd
Portland Va Medical Center
Portland, OR 97207
Phone: (303) 819-2848
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 3980
Wilsonville, OR 97070-1540
Registry dates
- Enumerated
- 2006-11-14
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.