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Individual

JENNA LEE ESTERBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
24076 SE STARK ST, SUITE 230, GRESHAM, OR 97030-3373
(503) 488-2600
(503) 465-5468
Mailing address
4400 NE HALSEY ST., POP 2- 4TH FLOOR, PORTLAND, OR 97213
(503) 893-6361
(503) 893-6891

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA162183
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1932548161
WA
05
500660295
OR
Enumeration date
06/20/2013
Last updated
03/11/2021
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