Individual
JENNIFER SARA SEMMELROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9701 SW BARNES RD, SUITE 300, PORTLAND, OR 97225-6772
(503) 297-8081
(503) 292-6601
Mailing address
847 NE 19TH AVE, SUITE 300, PORTLAND, OR 97232-2684
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA01085
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00834454
MEDICARE RAILROAD
OR
05
—
2039355
—
WA
05
—
500605524
—
OR
01
—
911019392
COMMERCIAL
—
Enumeration date
10/12/2006
Last updated
11/22/2021
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