Individual
DR. JENNIFER NICOLE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2435 NE CUMULUS AVE., STE A, MCMINNVILLE, OR 97128-8862
(503) 434-8286
Mailing address
2435 NE CUMULUS AVE., STE A, MCMINNVILLE, OR 97128-8862
(503) 434-8286
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
DO 167350
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DO167350
MEDICAL LICENSE
OR
Enumeration date
03/18/2011
Last updated
03/06/2024
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