Individual
MATTHEW JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9125 SW 55TH AVE, PORTLAND, OR 97219-5018
(503) 477-4622
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/22/2021
Last updated
11/22/2021
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