Individual
JESSICA WOODSIDE MONAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
9895 SE SUNNYSIDE RD STE F, CLACKAMAS, OR 97015-9745
(971) 300-0654
Mailing address
1002 NW 22ND AVE, CAMAS, WA 98607-7978
(530) 913-5398
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
202007707RN
OR
363LF0000X
Family Nurse Practitioner
10006008
OR
363LF0000X
Family Nurse Practitioner
Primary
61410145
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202007707RN
OREGON STATE LICENSE NUMBER
OR
Enumeration date
10/14/2022
Last updated
04/17/2023
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