Provider Demographics
NPI:1750445904
Name:NARKIEWICZ-JODKO, JOANNA B (MD)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:B
Last Name:NARKIEWICZ-JODKO
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 2120
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-2120
Mailing Address - Country:US
Mailing Address - Phone:541-274-3278
Mailing Address - Fax:541-274-3275
Practice Address - Street 1:3001 DAGGETT AVE STE 101
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-1126
Practice Address - Country:US
Practice Address - Phone:541-274-3278
Practice Address - Fax:541-274-3275
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD18197207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR057013Medicaid
060024273OtherRAILROAD MEDICARE
OR057013Medicaid
060024273OtherRAILROAD MEDICARE