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Individual

JACQUELINE TRUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AGACNP-BC, FNP-BC

Contact information

Practice address
3485 S BOND AVE, BUILDING 2, 11TH FLOOR, PORTLAND, OR 97239
(503) 494-5058
Mailing address
3485 S BOND AVE, BUILDING 2, 11TH FLOOR, PORTLAND, OR 97239-4503
(503) 494-5058

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
201350101NP
OR
363LF0000X
Family Nurse Practitioner
201350101NP
OR

Other

Enumeration date
05/14/2013
Last updated
12/09/2023
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