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Individual

AMANDA NOELLE JENKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
17675 SW TV HWY, BEAVERTON, OR 97003-4443
(503) 259-3160
Mailing address
484 N 10TH ST, SAINT HELENS, OR 97051-1311
(503) 438-5155

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
120622
OR

Other

Enumeration date
11/22/2019
Last updated
11/22/2019
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