Individual
JENNIPHER K. VALLERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1840 PORTLAND RD, NEWBERG, OR 97132-1847
(888) 227-3312
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-02887
NC
363A00000X
Physician Assistant
PA1269
NV
363A00000X
Physician Assistant
Primary
PA165170
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649562679
—
NV
05
—
500670807
—
OR
Enumeration date
05/10/2011
Last updated
09/24/2020
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