Individual
JENELLE LYNN STINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1015 NW 22ND AVE, PORTLAND, OR 97210-3025
(503) 413-7008
Mailing address
15875 SE HAROLD AVE, PORTLAND, OR 97267-3947
(503) 475-3206
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0014143
OR
Other
Enumeration date
08/22/2020
Last updated
08/22/2020
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