Individual
MRS. JESSICA JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-1983
(503) 494-1983
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(503) 494-1983
(503) 418-3683
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
200241905RN
OR
363LF0000X
Family Nurse Practitioner
Primary
200450101NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154339679
NPI
OR
Enumeration date
08/03/2006
Last updated
01/02/2019
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