Individual
IDA JEFSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1535 N WILLIAMS AVE, PORTLAND, OR 97227-1885
(971) 244-5311
Mailing address
6205 SE WOODSTOCK BLVD, PORTLAND, OR 97206-6648
(971) 222-9708
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201406356RN
OR
Other
Enumeration date
03/31/2015
Last updated
03/31/2015
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