Individual
JESSICA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5124 SW VIEW POINT TER, PORTLAND, OR 97239-3908
(503) 238-0769
Mailing address
5124 SW VIEW POINT TER, PORTLAND, OR 97239-3908
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/11/2007
Last updated
09/11/2007
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