Jonquil, Sharon Glass

Jonquil, Sharon Glass is an individual health care provider with primary practice located at 2800 N Vancouver Ave Legacy Midwifery Clinic, Ste 255, Portland OR 97227-1671. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Jonquil, Sharon Glass can be contacted via phone (503) 413-4500.

Contact Information

Primary practice address
2800 N Vancouver Ave Legacy Midwifery Clinic, Ste 255 Portland OR 97227-1671
Phone: (503) 413-4500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 089000405N5 Oregon

Profile Details

NPI number 1376510149
LBN Legal business name Jonquil, Sharon Glass
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2006
Last updated Oct 9th, 2008 - about 17 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 1376510149 NPPES
Oregon Other 138080 PTAN
Oregon MEDICAID 129580 PTAN

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