Individual
JEREMY DEAN ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
610 DRAGON DRIVE, MONROE, OR 97456-9604
(541) 766-6000
Mailing address
610 DRAGON DR, MONROE, OR 97456-9604
(541) 766-6000
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
201242599RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201242599RN
OREGON STATE BOARD OF NURSING
OR
Enumeration date
03/14/2022
Last updated
03/14/2022
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