Individual
JENNIFER ANN BROKAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4805 NE GLISAN ST, PORTLAND, OR 97213-2933
(503) 215-6190
Mailing address
4917 PARKVIEW DR APT A, LAKE OSWEGO, OR 97035-4474
(150) 372-6674
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
200441312RN
OR
Other
Enumeration date
10/04/2023
Last updated
10/04/2023
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