Jerry Everett King, M.D.
Radiology, Diagnostic Radiology in Clackamas, OR. Individual provider (NPI-1).
NPI number1154465482
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1154465482
- Entity type
- Individual (NPI-1)
- Name
- Jerry Everett King
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 19, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0202X | Radiology, Diagnostic Radiology | MD08996 | OR | Yes |
| 2085R0202X | Radiology, Diagnostic Radiology | MD00034639 | WA | |
| 2085R0202X | Radiology, Diagnostic Radiology | 30952 | AZ |
Practice location
10180 Se Sunnyside RdClackamas, OR 97015-8970
Phone 503-652-2880
Mailing address
10230 E Arrowvale DrSun Lakes, AZ 85248-7649
Phone 480-802-1259
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