Wollmuth, Jason Roland

Wollmuth, Jason Roland is an individual health care provider with primary practice located at 1111 Ne 99Th Ave Ste 201 , Portland OR 97220-9442. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Wollmuth, Jason Roland can be contacted via phone (503) 962-1000.

Contact Information

Primary practice address
1111 Ne 99Th Ave Ste 201 Portland OR 97220-9442
Phone: (503) 962-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD26636 Oregon
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X MD26636 Oregon

Profile Details

NPI number 1164498499
LBN Legal business name Wollmuth, Jason Roland
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2006
Last updated Oct 6th, 2020 - about 5 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 1164498499 NPPES
Oregon MEDICAID 240371

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