Welborn, Jody Marie

Welborn, Jody Marie is an individual health care provider with primary practice located at 1111 Ne 99Th Ave Suite 201, Portland OR 97220-9428. She recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as her primary health care specialty. Welborn, Jody Marie can be contacted via phone (503) 962-1000.

Contact Information

Primary practice address
1111 Ne 99Th Ave Suite 201 Portland OR 97220-9428
Phone: (503) 962-1000
Fax: (503) 963-3005
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD17908 Oregon

Profile Details

NPI number 1467445536
LBN Legal business name Welborn, Jody Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2005
Last updated Nov 11th, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467445536 NPPES
Oregon MEDICAID 045349

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