Individual
JENNA OTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7551
(503) 494-4997
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7551
(503) 494-4997
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
A154514
CA
207P00000X
Emergency Medicine Physician
Primary
MD197719
OR
207P00000X
Emergency Medicine Physician
MT298926
PA
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
MD197719
OR
Other
Enumeration date
06/11/2015
Last updated
10/18/2021
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