Individual
KAITLIN EMILY JERNSTEDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19250 SW 65TH AVE STE 125, TUALATIN, OR 97062-7745
(503) 692-1670
Mailing address
2081 NW EVERETT ST, APT. 506, PORTLAND, OR 97209-1045
(503) 816-3239
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
013503
OR
Other
Enumeration date
06/30/2011
Last updated
01/21/2020
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