Individual
JENNIFER A. MCKINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1077 GATEWAY LOOP, SPRINGFIELD, OR 97477-1114
(541) 485-6478
(541) 868-9606
Mailing address
1077 GATEWAY LOOP, SPRINGFIELD, OR 97477-1114
(541) 485-6478
(541) 868-9606
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA180572
OR
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5007178902
—
OR
01
—
PA180572
MEDICAL LICENSE
OR
Enumeration date
04/14/2015
Last updated
03/26/2024
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