Provider Demographics
NPI:1427002187
Name:BUTTON, JEANNE H (MD)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:H
Last Name:BUTTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JEANNE
Other - Middle Name:
Other - Last Name:BUTTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 3808
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3808
Mailing Address - Country:US
Mailing Address - Phone:503-413-3900
Mailing Address - Fax:
Practice Address - Street 1:1040 NW 22ND AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3057
Practice Address - Country:US
Practice Address - Phone:503-413-6294
Practice Address - Fax:503-413-7780
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD281032081S0010X, 208100000X
TXM3945208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX186805102Medicaid
TX186805101Medicaid
OR242574Medicaid
TX8J3571Medicare PIN
TX8J3574Medicare PIN
TX186805102Medicaid
TX8J3573Medicare PIN
OR242574Medicaid