Jeff Wakeham

Specialist · Gresham, OR

Individual Active NPI

NPI number 1467631374

Practice location

4101 NE Division St
Suite # 100
Gresham, OR 97030-4617
Phone
(503) 666-3808
Fax
(503) 666-6835

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NPI record

NPI
1467631374
Entity type
Individual (Type 1)
Enumeration date
October 26, 2007
Last updated
October 26, 2007
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Specialist Primary 174400000X — —

Mailing address

7540 Charolais Ct
Gladstone, OR 97027-1259
Phone
(503) 557-7903

About Jeff Wakeham

Jeff Wakeham is a healthcare provider registered in the NPI registry with the primary taxonomy Specialist (code 174400000X). The practice location is 4101 NE Division St, Suite # 100, Gresham, OR 97030-4617. The NPI number 1467631374 was assigned on October 26, 2007 and the record was last updated on October 26, 2007.

Frequently asked questions

What is the NPI number of Jeff Wakeham?

The NPI number is 1467631374.

What is the phone number of Jeff Wakeham?

The phone number listed for the practice location is (503) 666-3808.

Where is Jeff Wakeham located?

4101 NE Division St, Suite # 100, Gresham, OR 97030-4617.

What is the taxonomy code for Jeff Wakeham?

The primary taxonomy code is 174400000X – Specialist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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