Individual
JENNIFER ANN GAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C, MSN, RN
Contact information
Practice address
4550 KRUSE WAY STE 125, LAKE OSWEGO, OR 97035-3533
(503) 360-7650
Mailing address
4550 KRUSE WAY STE 125, LAKE OSWEGO, OR 97035-3533
(503) 360-7650
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10027962
OR
Other
Enumeration date
02/04/2019
Last updated
02/10/2026
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