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Individual

MISS JESICA JAMES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPM, LDM

Contact information

Practice address
19255 SW 65TH AVE STE 220, TUALATIN, OR 97062-9717
(503) 885-0228
Mailing address
4903 SE 64TH AVE, PORTLAND, OR 97206-4641
(503) 702-5392

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
1004154
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
278230
OR
Enumeration date
07/02/2007
Last updated
07/09/2007
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