Individual
JESSICA MARIE CAUDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97232-2941
(503) 232-1099
Mailing address
30 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97232-2941
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
202000259RN
OR
Other
Enumeration date
02/01/2022
Last updated
02/01/2022
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