MEDICARE: EMILY PATTERSON JONES 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	207W00000X	Ophthalmology Physician	MD 00045471	WA
2	207W00000X	Ophthalmology Physician	MD 25236	OR
3	207W00000X	Ophthalmology Physician	MD25236	OR

Other Identifiers

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

General Provider Information

NPI Number	:	1699882902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY PATTERSON JONES M.D.

Provider Business Mailing Address
First Line	:	1040 NW 22ND AVENUE
Second Line	:	STE. 200
City	:	PORTLAND
State	:	OR
Zip	:	97210-3049
Country	:	US
Telephone Number	:	503-413-8202
Fax Number	:	503-413-3970

Provider Business Practice Location Address
First Line	:	1040 NW 22ND AVENUE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97210-3049
Country	:	US
Telephone Number	:	503-413-8202
Fax Number	:	503-413-6937

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

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	02/17/2020

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