Individual
JESSICA JO TACKE-HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9900 BREN RD E, MAIL ROUTE MN 008-B213, MINNETONKA, MN 55343-9664
(503) 430-9777
Mailing address
17360 S HOLLY LN, OREGON CITY, OR 97045-9010
(503) 320-6596
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200650066NP
OR
Other
Enumeration date
06/26/2007
Last updated
07/13/2020
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