Healthcare Provider Details

I. General information

NPI: 1245792746
Provider Name (Legal Business Name): JON-MICHAEL ANTHONY SAENZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2019
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 KERR PKWY
LAKE OSWEGO OR
97035-8881
US

IV. Provider business mailing address

50 KERR PKWY
LAKE OSWEGO OR
97035-8881
US

V. Phone/Fax

Practice location:
  • Phone: 774-314-1223
  • Fax: 774-220-8373
Mailing address:
  • Phone: 774-314-1223
  • Fax: 774-220-8373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberMD224325
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD224325
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number292754
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2024-02091
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: