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General NPI Number Information
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NPI Number | 1811019383
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Entity Type | Individual
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Provider Name | JEFFREY MICHAEL POLLOCK MD
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Gender | Male
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 01/12/2021
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Provider Practice Location Address
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Address Line | 19300 SW 65TH AVE
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City | TUALATIN
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State | OR
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Zip | 97062-7706
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Country | US
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Telephone | 503-692-1212
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Fax | 503-692-5307
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Provider Business Mailing Address
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Address Line | PO BOX 488
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City | TUALATIN
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State | OR
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Zip | 97062-0488
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Country | US
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Telephone | 805-286-3826
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Fax | 805-221-6843
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | MD27981
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 200501952
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 200501952
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD27981
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License Number State | OR
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