MEDICARE: DR. TREVOR DEE JORGENSEN M.D.

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	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	MD166203	OR

General Provider Information

NPI Number	:	1639303597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TREVOR DEE JORGENSEN M.D.

Provider Business Mailing Address
First Line	:	2005 CEDAR ST
Second Line	:
City	:	FOREST GROVE
State	:	OR
Zip	:	97116-1701
Country	:	US
Telephone Number	:	503-883-8297
Fax Number	:	503-836-7568

Provider Business Practice Location Address
First Line	:	2005 CEDAR ST
Second Line	:
City	:	FOREST GROVE
State	:	OR
Zip	:	97116-1701
Country	:	US
Telephone Number	:	503-883-8297
Fax Number	:	503-836-7568

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

Provider Enumeration Date	:	05/07/2009
Last Update Date	:	02/03/2022

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Directions to “ DR. TREVOR DEE JORGENSEN M.D.” Practice Location

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