Individual
JENNIFER INGRID BEAUDOIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
99 CENTRAL AVE, ASHLAND, OR 97520-1787
(541) 482-9741
(541) 488-6141
Mailing address
1221 DISK DR, MEDFORD, OR 97501-6638
(541) 488-6141
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA163353
OR
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500677182
—
OR
Enumeration date
07/25/2013
Last updated
09/21/2023
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