Individual
JENNIFER RUTH CHRISTENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-2099
(541) 267-5151
(407) 425-5203
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-2099
(541) 267-5151
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
DO181810
OR
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
OS15571
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500721760
—
OR
Enumeration date
05/21/2012
Last updated
01/18/2021
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