Provider Demographics
NPI:1699882902
Name:JONES, EMILY PATTERSON (MD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:PATTERSON
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:LYNNE
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1040 NW 22ND AVENUE
Mailing Address - Street 2:STE. 200
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-3049
Mailing Address - Country:US
Mailing Address - Phone:503-413-8202
Mailing Address - Fax:503-413-3970
Practice Address - Street 1:1040 NW 22ND AVENUE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3049
Practice Address - Country:US
Practice Address - Phone:503-413-8202
Practice Address - Fax:503-413-6937
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD 00045471207W00000X
ORMD 25236207W00000X
ORMD25236207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500603823Medicaid
OR500603823Medicaid