Provider Demographics
NPI:1275636680
Name:JEW, BEN CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:BEN
Middle Name:CHRISTOPHER
Last Name:JEW
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 1:818 NW 17TH AVE
Mailing Address - Street 2:SUITE #8
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-2327
Mailing Address - Country:US
Mailing Address - Phone:503-764-1551
Mailing Address - Fax:
Practice Address - Street 1:818 NW 17TH AVE
Practice Address - Street 2:SUITE #8
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-2327
Practice Address - Country:US
Practice Address - Phone:503-764-1551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD265642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR137745Medicare UPIN