Individual
JENNIFER MCCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
360 NW BURNSIDE RD, GRESHAM, OR 97030-3852
(503) 667-7480
Mailing address
2317 SE 85TH AVE, PORTLAND, OR 97216-2002
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
01/24/2007
Last updated
07/08/2007
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