Individual
JEAN L NASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
545 NE 47TH AVE, SUITE 106, PORTLAND, OR 97213-2238
(503) 215-9700
(503) 215-9701
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
079043598
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210820
—
OR
01
—
500008367
RR MEDICARE
OR
Enumeration date
05/24/2006
Last updated
06/12/2008
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