Individual
JADE TINNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8935 SW CENTER ST, TIGARD, OR 97223-6307
(503) 726-3750
Mailing address
8935 SW CENTER ST, TIGARD, OR 97223-6307
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
202200650RN
OR
Other
Enumeration date
05/08/2024
Last updated
05/08/2024
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