Jaczko, Michael P.
Jaczko, Michael P. is an individual health care provider with primary practice located at 1000 N Providence Dr Ste 210 , Newberg OR 97132-7582. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jaczko, Michael P. can be contacted via phone (503) 537-5900.Contact Information
Primary practice address
1000 N Providence Dr Ste 210
Newberg OR 97132-7582
Phone: (503) 537-5900
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | DO20026 | Oregon |
Profile Details
| NPI number | 1487647954 |
|---|---|
| LBN Legal business name | Jaczko, Michael P. |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2005 |
| Last updated | Mar 18th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487647954 | NPPES |
| Oregon | MEDICAID | 151081 |
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