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NPI Code Detail

MEDICARE: JENNIFER E BISHOP MD

MEDICARE: JENNIFER E BISHOP MD
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
1207R00000XInternal Medicine PhysicianMD25627OR

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00672645OTHERORRR MEDICARE (PH&S)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548284557
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER E BISHOP MD
Provider Business Mailing Address
First Line : 4410 NE FAILING ST
Second Line :
City : PORTLAND
State : OR
Zip : 97213-1056
Country : US
Telephone Number : 503-734-8683
Fax Number :
Provider Business Practice Location Address
First Line : 19500 SE STARK ST
Second Line :
City : PORTLAND
State : OR
Zip : 97233-5757
Country : US
Telephone Number : 800-813-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 09/12/2024

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