Individual
RIA JENAE SISK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRM
Contact information
Practice address
10564 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(503) 888-3656
Mailing address
200 S LONGVIEW WAY APT 68, OREGON CITY, OR 97045-1356
(503) 888-3656
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
16-CRM-153
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175T00000X
—
OR
Enumeration date
03/09/2018
Last updated
03/09/2018
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