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Contact Information

JORDAN B HORROCKS, PA-C
11782 SW BARNES RD
SUITE 300
PORTLAND, OR97225-5914
 Phone: 503-214-5200
 Fax: 503-906-6613
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for JORDAN B HORROCKS · (Male)

NPI # 1558538140
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 05/13/2008
Last updated 05/23/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • OR License # PA165164
  • OR Medicaid 500668334
  • OR Other PA165164 PA LICENSE
Hospital affiliation(s)
  • PROVIDENCE PORTLAND MEDICAL CENTER - (Acute Care)
    4805 NE GLISAN STREET
    PORTLAND, OR 97213
  • PROVIDENCE ST VINCENT MEDICAL CENTER - (Acute Care)
    9205 SW BARNES ROAD
    PORTLAND, OR 97225
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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