Individual
JENNIFER S MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4411 SW VERMONT ST, PORTLAND, OR 97219-1020
(503) 494-9992
(503) 494-9196
Mailing address
4411 SW VERMONT ST, PORTLAND, OR 97219-1020
(503) 494-9992
(503) 494-9196
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA153534
OR
363AM0700X
Medical Physician Assistant
PA153534
OR
Other
Enumeration date
04/07/2009
Last updated
12/21/2020
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