Individual
JILLIAN CONRAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
BOB CHISHOLM CENTER, 1225 AVE. A, SEASIDE, OR 97138
(503) 738-3311
Mailing address
768 FLORENCE AVE, ASTORIA, OR 97103-5833
(360) 348-0397
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174H00000X
—
OR
Enumeration date
02/23/2021
Last updated
02/23/2021
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