Individual
CHRISTY JACOBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11050 SE CHERRY BLOSSOM DR, PORTLAND, OR 97216-3540
(702) 773-7869
Mailing address
11050 SE CHERRY BLOSSOM DR, PORTLAND, OR 97216-3540
(702) 773-7869
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
Primary
201608791RN
OR
Other
Enumeration date
09/17/2021
Last updated
09/17/2021
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