IndividualActive
Jed Peterson, M.D.
NPI 1164634770 · Vascular & Interventional Radiology Physician · Portland, OR
Provider details
- NPI number
- 1164634770
- Entity type
- Individual
- Primary specialty
- Vascular & Interventional Radiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- MD.60212410 (WA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
10123 Se Market St
Department of Radiology
Portland, OR 97216-2532
Phone: (503) 251-6137
Fax: (503) 261-6058
Approximate (ZIP-level) locationGet directions
Mailing address
10123 Se Market St
Portland, OR 97216-2532
Registry dates
- Enumerated
- 2007-05-04
- Last updated
- 2012-10-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.