Individual
DR. JENNIFER ANN ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4805 NE GLISAN ST, SUITE BG05, PORTLAND, OR 97213-2933
(503) 215-2393
(503) 215-6918
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD00046538
WA
207R00000X
Internal Medicine Physician
MD27077
OR
208M00000X
Hospitalist Physician
Primary
MD27077
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274353
—
OR
01
—
P00465311
RAILROAD MEDICARE
OR
Enumeration date
06/23/2006
Last updated
03/24/2021
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