Individual
JESSIE LYNNE VANDOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3303 S BOND AVE, PORTLAND, OR 97239-4501
(503) 494-4373
(503) 418-4189
Mailing address
3303 S BOND AVE, PORTLAND, OR 97239-4501
(503) 494-4373
(503) 418-4189
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA223585
OR
363AM0700X
Medical Physician Assistant
Primary
PA223585
OR
Other
Enumeration date
10/20/2023
Last updated
04/09/2025
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