Provider Demographics
NPI:1487766929
Name:PALMGREN, JEFFREY SCOTT (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:SCOTT
Last Name:PALMGREN
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 1:400 HICKORY STREET NW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1700
Mailing Address - Country:US
Mailing Address - Phone:541-812-5800
Mailing Address - Fax:541-812-5802
Practice Address - Street 1:400 HICKORY STREET NW
Practice Address - Street 2:SUITE 200
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1700
Practice Address - Country:US
Practice Address - Phone:541-812-5800
Practice Address - Fax:541-812-5802
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD156143208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology