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Individual

ADRIANA C JANTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
4115 SE HAGER LN, PORTLAND, OR 97267-2925
(503) 997-7258
Mailing address
20150 SW JETTE LN, BEAVERTON, OR 97003-6561

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
098003150RN
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
509355
DHS
OR
Enumeration date
06/27/2017
Last updated
06/27/2017
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