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Individual

JAMIE LEE WEGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, NNP

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8122
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8122

Taxonomy

Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
200841512RN
OR
363LN0000X
Neonatal Nurse Practitioner
Primary
200850080NP
OR

Other

Enumeration date
07/15/2008
Last updated
07/15/2008
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