Individual ProviderJonathan Scott EmensPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansPractice Address3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011(503) 494-6176PECOS EnrollmentBased on the most recent information from CMS, provider Jonathan Scott Emens does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1962410415Provider TypeIndividualFull NameEmens, Jonathan ScottCredentialMDGenderMaleSole ProprietorNoEnumeration Date8/3/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011Phone(503) 494-6176FaxUnlisted FaxMailing LocationMailing Address2304 SE Ladd Ave, Portland, OR 97214-5425PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode2084P0800XPrimaryDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicenseMD23635OregonProvider IdentifiersIDDescriptionIssuerID286631DescriptionMedicaidIssuerUnlistedOregon