JERRY WANG OP NPI 1376119883

NPI Information

  • NPI: 1376119883
  • Provider Name: JERRY WANG, OP
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3550 N INTERSTATE AVE
    PORTLAND, OR
    ZIP 97227
  • Phone: (321) 576-8536

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NPI Details

Jerry Wang, OP is a family medicine in Portland, OR with 4 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Jerry Wang, OP NPI is 1376119883. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TOURO UN COL OF OSTEOPATHIC MEDICINE, HENDERSON
Graduation Year:2021

The provider's business location address is:

3550 N INTERSTATE AVE
PORTLAND, OR
ZIP 97227-196
Phone: (321) 576-8536

The NPI 1376119883 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/3/2021 and was last updated on 9/24/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1390200000XStudent in an Organized Health Care Education/Training ProgramOP61170696WASHINGTONNo
2207Q00000XFamily MedicineOP61170696WASHINGTONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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