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Individual

MS. JESSICA ANN OWENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
14516 E BURNSIDE ST, PORTLAND, OR 97233-2142
(503) 253-9041
Mailing address
2702 SE 174TH AVE, PORTLAND, OR 97236-1006
(503) 309-6495

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201230150LPN
OR

Other

Enumeration date
09/10/2014
Last updated
09/10/2014
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