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Jeffrey Donovan

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

3181 SW Sam Jackson Park Rd, L586, Portland, OR 97239-3011

PECOS Enrollment

Based on the most recent information from CMS, provider Jeffrey Donovan is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1649727868
Provider Type
Individual
Full Name
Donovan, Jeffrey
Credential
PA-C

Gender
Male
Sole Proprietor
Yes
Enumeration Date
9/6/2016
Last Updated
9/6/2016

Contact Information

Practice Location

3181 SW Sam Jackson Park Rd, L586, Portland, OR 97239-3011

(541) 285-7427

Unlisted Fax

Mailing Location

3181 SW Sam Jackson Park Rd, L586, Portland, OR 97239-3011

(541) 285-7427

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA179246 Oregon

Jeffrey Donovan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Jones, Carmen M

Ahmad, Zoha

Frey, Julia Alice

Keller, Kelly Rene

Kuzma, Laura

Kading, Laura

Skolnik, Kevin

Atwood, Ashley

Rogers, Samuel

Barwood, Gwen Lynn