Individual
DR. MANDIE WIEBERS JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
707 SW GAINES ST, PORTLAND, OR 97239-2901
(503) 452-3563
(503) 494-4447
Mailing address
707 SW GAINES ST, PORTLAND, OR 97239-2901
(503) 452-3563
(503) 494-4447
Taxonomy
Speciality
Code
Description
License number
State
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
MD193592
OR
Other
Enumeration date
04/09/2014
Last updated
08/10/2020
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