IndividualActive
Gary Jacobsen, MD
NPI 1497998587 · Specialist · Portland, OR
Provider details
- NPI number
- 1497998587
- Entity type
- Individual
- Primary specialty
- SpecialistOther Service Providers
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- MC08382 (OR)
Specialties & taxonomies
Other Service Providers
Practice location
6327 Sw Capitol Hwy. , Suite C
Pmb 211
Portland, OR 97239
Phone: (503) 245-1274
Approximate (ZIP-level) locationGet directions
Mailing address
6327 Sw Capitol Hwy. , Suite C
Portland, OR 97239
Registry dates
- Enumerated
- 2009-04-20
- Last updated
- 2009-04-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.