Jacquelyn Alice Bennett RN

NPI 1083964704 - Registered Nurse - 163WG0600X

NPI Details
NPI 1083964704
Gender Female
Enumeration Date 09/11/2012
Last Updated 09/11/2012
Entity Type Individual
Active Over 4 years ago
Practice Location
4540 NE GLISAN ST
PORTLAND OR, 97213-2333, US
Phone (503) 215-3738
Fax
Business Location
4540 NE GLISAN ST
PORTLAND OR, 97213-2333, US
Phone (503) 215-3738
Fax
Toxanomy
Taxonomy Code 163WG0600X
License State Oregon
License Number 200340760RN
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According to our database, Mrs. Jacquelyn Alice Bennett RN NPI is 1083964704, taxonomy code is 163WG0600X and license number is 200340760RN, license state is located at Oregon. Jacquelyn Alice Bennett RN physically located at 4540 Ne Glisan St, Portland OR, 97213-2333. NPI Number Jacquelyn Alice Bennett RN has the Individual type.

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1083964704 NPI number is provided on an as is basis without warranty of any kind. 1083964704 is maintained by the National Plan & Provider Enumeration System. The contents of Jacquelyn Alice Bennett RN are for informational purposes only.