Individual
JENNIFER ANNE HARTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1312 SW WASHINGTON ST, PORTLAND, OR 97205-2327
(503) 535-1150
Mailing address
PO BOX 3007, PORTLAND, OR 97208-3007
(503) 535-1150
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD170757
OR
207Q00000X
Family Medicine Physician
RS20080413
NM
Other
Enumeration date
08/25/2008
Last updated
08/26/2020
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