Individual
JESSICA BODNAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2043 COLLEGE WAY, FOREST GROVE, OR 97116-1797
(503) 352-6151
Mailing address
115 SE 143RD AVE, PORTLAND, OR 97233-2113
(503) 954-5647
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/08/2025
Last updated
05/08/2025
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