Individual
JESSICA MARIE VAN FLEET-GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
555 INTERNATIONAL WAY # B104, SPRINGFIELD, OR 97477-6013
(458) 544-0400
Mailing address
555 INTERNATIONAL WAY # B104, SPRINGFIELD, OR 97477-6013
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD179549
OR
207Q00000X
Family Medicine Physician
MD179549
WA
207Q00000X
Family Medicine Physician
Primary
MD60162757
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679736318
—
WA
01
—
273408
L&I
WA
Enumeration date
07/02/2008
Last updated
05/06/2026
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