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Individual

MEGAN ELIZABETH JACKLIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
3303 S BOND AVE FL 10, PORTLAND, OR 97239-4501
(503) 418-3700
Mailing address
5712 S CORBETT AVE, PORTLAND, OR 97239-3706
(949) 838-4862

Taxonomy

Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
202109740NP-PP
OR
367A00000X
Advanced Practice Midwife
Primary
202109740NP-PP
OR

Other

Enumeration date
09/19/2021
Last updated
09/19/2021
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