Individual
SHEROLYN J JENNART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2500 NE NEFF RD, BEND, OR 97701-6015
(541) 388-1636
(541) 388-1719
Mailing address
PO BOX 5579, BEND, OR 97708-5579
(541) 388-1636
(541) 388-1719
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA10004809
WA
363A00000X
Physician Assistant
Primary
PA164738
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8471255
—
WA
Enumeration date
01/19/2007
Last updated
05/02/2023
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