Individual provider · Type 1 NPI

Jed Russell Peterson, MD

Vascular & Interventional Radiology Physician · Portland, OR

NPI number 1164634770 Active

Practice location

10123 SE Market St, Department Of Radiology
Portland, OR 97216-2532

Call (503) 251-6137 Map

Fax (503) 261-6058

Specialties and licenses

TaxonomyCodeLicense
Diagnostic Radiology Physician 2085R0202XMD.60212410 (WA)
Vascular & Interventional Radiology Physician 2085R0204XMD.60212410 (WA)
Diagnostic Radiology Physician 2085R0202X157199 (OR)
Vascular & Interventional Radiology Physician Primary 2085R0204X157199 (OR)

Vascular & Interventional Radiology Physician: A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.

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About NPI 1164634770

Jed Russell Peterson, MD's National Provider Identifier is 1164634770, issued on May 4, 2007. The primary taxonomy on file is Vascular & Interventional Radiology Physician (2085R0204X), and the practice location is in Portland, OR. The record was last updated on Oct 15, 2012.