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Contact Information

BARRY A JACOSHENK, PA-C
1515 NW 18TH AVE
SUITE 300
PORTLAND, OR97209-2516
 Phone: 503-224-8399
 Fax: 503-224-5661
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for BARRY A JACOSHENK · (Male)

NPI # 1376600049
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 01/02/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • OR License # PA00938
Hospital affiliation(s)
  • PROVIDENCE PORTLAND MEDICAL CENTER - (Acute Care)
    4805 NE GLISAN STREET
    PORTLAND, OR 97213
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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