MEDICARE: JEFFREY ERIC PHILLIPS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	MD229155	OR

General Provider Information

NPI Number	:	1588312193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY ERIC PHILLIPS

Provider Business Mailing Address
First Line	:	3181 SW SAM JACKSON PARK RD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97239-3011
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3181 SW SAM JACKSON PARK RD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97239-3011
Country	:	US
Telephone Number	:	347-364-2039
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2022
Last Update Date	:	05/04/2026

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Directions to “ JEFFREY ERIC PHILLIPS ” Practice Location

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