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Individual

JENNIFER DYAN ERKENBECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7641
Mailing address
19279 REDDAWAY AVE, OREGON CITY, OR 97045-7298
(503) 805-6058

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200841526RN
OR
363LA2100X
Acute Care Nurse Practitioner
Primary
201509500NP-PP
OR

Other

Enumeration date
12/18/2015
Last updated
01/26/2016
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