Individual
JENNIFER L SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDM, CPM
Contact information
Practice address
4861 SE 64TH AVE, PORTLAND, OR 97206-4639
(503) 467-8697
Mailing address
4903 SE 64TH AVE, PORTLAND, OR 97206-4641
(503) 467-8697
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
DEMLD10144711
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500648827
—
OR
Enumeration date
11/21/2011
Last updated
12/10/2012
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