Individual
JAIME GWEN FAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 NE MULTNOMAH ST STE 100, PORTLAND, OR 97232-2031
(503) 813-3860
Mailing address
3529 KING GEORGE DR, ORLANDO, FL 32835-5907
(407) 409-0101
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
10055513
OR
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/10/2025
Last updated
02/11/2026
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