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NPI Code Detail

MEDICARE: DR. JEFFREY LEE KATZ MD

MEDICARE: DR. JEFFREY LEE KATZ 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
1207Q00000XFamily Medicine PhysicianMD24537OR
2207Q00000XFamily Medicine Physician68370MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2P00061508OTHERRR PIN

General Provider Information

NPI Number : 1992757264
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY LEE KATZ MD
Provider Business Mailing Address
First Line : 12096 NW HALLBROOK LN
Second Line :
City : PORTLAND
State : OR
Zip : 97229-8428
Country : US
Telephone Number : 503-208-4116
Fax Number : 503-213-6510
Provider Business Practice Location Address
First Line : BEAVERTON MEDICAL OFFICE
Second Line : 4855 SW WESTERN AVE
City : BEAVERTON
State : OR
Zip : 97005-3460
Country : US
Telephone Number : 971-217-7506
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 02/26/2025

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