Individual
JESSIE NUGENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2031 SE BELMONT ST, PORTLAND, OR 97214-2812
(907) 854-5023
Mailing address
2031 SE BELMONT ST, PORTLAND, OR 97214-2812
(907) 854-5023
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
BAP-E-10258400
OR
Other
Enumeration date
07/23/2025
Last updated
12/19/2025
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