Individual
JENNIFER NOVACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11611 NE AINSWORTH CIR, PORTLAND, OR 97220-9017
(503) 257-1732
Mailing address
925 S PALATINE HILL RD, PORTLAND, OR 97219-8088
(971) 291-3075
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
094000186RN
OR
Other
Enumeration date
03/19/2026
Last updated
03/19/2026
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