Provider Demographics
NPI:1497947873
Name:HAYES, JOCELYN (MD)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:HAYES
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 1:9555 SW BARNES RD STE 301
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6670
Mailing Address - Country:US
Mailing Address - Phone:503-297-3371
Mailing Address - Fax:503-297-3375
Practice Address - Street 1:9555 SW BARNES RD STE 301
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6670
Practice Address - Country:US
Practice Address - Phone:503-297-3371
Practice Address - Fax:503-297-3375
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD166647208000000X
WAMD60082828208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics