IndividualActive
Barry Jacoshenk, PA-C
NPI 1376600049 · Surgical Physician Assistant · Portland, OR
Provider details
- NPI number
- 1376600049
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- PA00938 (OR)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1515 Nw 18th Ave
Suite 300
Portland, OR 97209-2516
Phone: (503) 224-8399
Fax: (503) 224-5661
Approximate (ZIP-level) locationGet directions
Mailing address
1515 Nw 18th Ave
Portland, OR 97209-2516
Registry dates
- Enumerated
- 2007-01-02
- 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.