Provider Demographics
NPI:1407802143
Name:MARFORI, JENNIFER E (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
Last Name:MARFORI
Suffix:
Gender:F
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:PO BOX 3158
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3158
Mailing Address - Country:US
Mailing Address - Phone:503-215-6494
Mailing Address - Fax:503-215-6644
Practice Address - Street 1:9155 SW BARNES RD STE 638
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6633
Practice Address - Country:US
Practice Address - Phone:503-216-7000
Practice Address - Fax:503-216-6999
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD23882207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR227432Medicaid
ORP00443585OtherRR MEDICARE
ORR138992Medicare PIN
ORH93275Medicare UPIN
ORP00443585OtherRR MEDICARE