Individual
LAURA ADAMS JETMALANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
707 SW GAINES ST, PORTLAND, OR 97239-2901
(800) 452-3563
Mailing address
5708 SUNCREEK DR, LAKE OSWEGO, OR 97035-8777
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
82010753RN
OR
363LP0200X
Pediatric Nurse Practitioner
Primary
—
OR
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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