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Individual

DR. JENNIFER LYCETTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
725 S WAHANNA RD STE 100, SEASIDE, OR 97138-7735
(503) 717-7650
(971) 712-2199
Mailing address
PO BOX 3397, PORTLAND, OR 97208-3397
(503) 717-7443
(971) 712-2199

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD00045720
WA
207RX0202X
Medical Oncology Physician
Primary
MD24559
OR

Other

Enumeration date
05/12/2006
Last updated
03/19/2021
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