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Individual
JESSIE LYNNE VANDOR
Active
Individual
JESSIE LYNNE VANDOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA223585
OR
363AM0700X
Medical Physician Assistant
PA.PA.61659084
WA
363AM0700X
Medical Physician Assistant
Primary
PA223585
OR
Other
Enumeration date
10/20/2023
Last updated
09/01/2026
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