Individual
JESSICA NICOLE GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRM
Contact information
Practice address
608 SW HURBERT ST APT 2, NEWPORT, OR 97365-4938
(541) 272-3315
Mailing address
200 GWEE SHUT RD, SILETZ, OR 97380-2036
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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