Individual
JEMIMAH MANZANO BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
619 N OAK HOLLOW DR, NEWBERG, OR 97132-7475
(971) 227-0028
Mailing address
619 N OAK HOLLOW DR, NEWBERG, OR 97132-7475
(971) 227-0028
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
201607880RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33-1809779
IRS
OR
Enumeration date
11/07/2024
Last updated
11/07/2024
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