Individual
JACLYN MARIE WINFREE HOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10373 NE HANCOCK ST STE 125, PORTLAND, OR 97220-3873
(503) 253-6754
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
10023286
OR
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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