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Individual

JACOB GABRIEL KIRKWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PMHNP

Contact information

Practice address
10151 SE SUNNYSIDE RD STE 480, HAPPY VALLEY, OR 97015-5705
(503) 739-8321
Mailing address
10151 SE SUNNYSIDE RD STE 480, HAPPY VALLEY, OR 97015-5705
(503) 739-8321

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201607151
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10011841
OR

Other

Enumeration date
07/18/2023
Last updated
07/18/2023
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