JEFF WAKEHAM

Specialist

Active Individual
NPI: 1467631374

Practice Address

4101 NE DIVISION ST
SUITE # 100
Gresham, OR 97030

Phone: (503) 666-3808

Specialties

Specialty Code Primary License
Specialist 174400000X Yes -

Frequently Asked Questions

NPI 1467631374 is the National Provider Identifier for JEFF WAKEHAM, a Specialist provider located in Gresham, OR. This NPI was enumerated on October 26, 2007.
JEFF WAKEHAM practices at 4101 NE DIVISION ST, SUITE # 100, Gresham, OR 97030.

Quick Facts

NPI
1467631374
Type
Individual
Enumerated
Oct 26, 2007
Last Updated
Oct 26, 2007

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