Provider Demographics
NPI:1306962774
Name:JAIN, NIERAJ (MD)
Entity type:Individual
Prefix:DR
First Name:NIERAJ
Middle Name:
Last Name:JAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3375 SW TERWILLIGER BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4146
Mailing Address - Country:US
Mailing Address - Phone:503-494-3000
Mailing Address - Fax:
Practice Address - Street 1:3375 SW TERWILLIGER BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4146
Practice Address - Country:US
Practice Address - Phone:503-494-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301100190207W00000X
ORMD167657207W00000X
NC2011-00921207W00000X
GA73153207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology