Healthcare Provider Details

I. General information

NPI: 1780049098
Provider Name (Legal Business Name): JAYCANNA MICHELLE DAY PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAYCANNA DAY MCVEY

II. Dates (important events)

Enumeration Date: 12/31/2015
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

649 NE HOOD AVE
GRESHAM OR
97030-7328
US

IV. Provider business mailing address

15541 SE STEPHENS CT
PORTLAND OR
97233-3361
US

V. Phone/Fax

Practice location:
  • Phone: 971-997-0415
  • Fax: 503-588-4788
Mailing address:
  • Phone: 971-997-0415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number109938
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: