Individual
JENSEN D CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, FNP-BC
Contact information
Practice address
2510 SE 122ND AVE, PORTLAND, OR 97236-3101
(855) 203-6352
Mailing address
2620 SE 122ND AVE, PORTLAND, OR 97236-3103
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201901581RN
OR
363LF0000X
Family Nurse Practitioner
Primary
201908821NP-PP
OR
Other
Enumeration date
10/03/2019
Last updated
05/13/2026
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