Botelho, Jennifer

Botelho, Jennifer is an individual health care provider with primary practice located at 1130 Nw 22Nd Ave Ste 535 , Portland OR 97210-2976. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Botelho, Jennifer can be contacted via phone (503) 274-4999.

Contact Information

Primary practice address
1130 Nw 22Nd Ave Ste 535 Portland OR 97210-2976
Phone: (503) 274-4999
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA00838 Oregon

Profile Details

NPI number 1891782751
LBN Legal business name Botelho, Jennifer
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2005
Last updated Aug 26th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891782751 NPPES
Washington MEDICAID 8404378
Washington Other 191806
Washington MEDICAID PA00838

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