Jefferson Overlin Abaricia, MD, PhD
Student in an Organized Health Care Education/Training Program in Portland, OR. Individual provider (NPI-1).
NPI number1073215711
StatusActive
Last updated in NPPESMar 20, 2023
Details
- NPI
- 1073215711
- Entity type
- Individual (NPI-1)
- Name
- Jefferson Overlin Abaricia
- Credential
- MD, PhD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 20, 2023
- Certification date
- Mar 18, 2023
- Last updated
- Mar 20, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
3181 Sw Sam Jackson Park RdPortland, OR 97239-3011
Phone 503-494-8311
Mailing address
3181 Sw Sam Jackson Park RdPortland, OR 97239-3011
Phone 503-494-8311
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