Individual
JENNIFER L TRAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN/ BC
Contact information
Practice address
4531 SE BELMONT ST, STE 100, PORTLAND, OR 97215-1675
(503) 760-2075
Mailing address
14009 NE 9TH ST, VANCOUVER, WA 98684-7303
(503) 929-9276
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
Primary
0960000640RN
OR
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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