Individual
JENNIFER M LUNDGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2235 NW SHEVLIN PARK RD STE 140, BEND, OR 97703-7111
(541) 317-0808
Mailing address
2235 NW SHEVLIN PARK RD STE 140, BEND, OR 97703-7111
(541) 317-0808
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA223243
OR
363A00000X
Physician Assistant
PA61448964
WA
363AM0700X
Medical Physician Assistant
PA61448964
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2284734
—
WA
Enumeration date
06/05/2022
Last updated
06/18/2025
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