Individual
JENNIFER T CHILDRESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM LDM
Contact information
Practice address
40660 NORTHFORK RD, NEHALEM, OR 97131-9511
(503) 368-5886
(503) 368-5886
Mailing address
40660 NORTHFORK RD, NEHALEM, OR 97131-9511
(503) 368-5886
(503) 368-5886
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
DEM-LD-10143021
OR
Other
Enumeration date
09/27/2010
Last updated
07/18/2011
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