Siebold, Jennifer J

Siebold, Jennifer J is an individual health care provider with primary practice located at 2525 Nw Lovejoy St Ste 200, Portland OR 97210-2863. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Siebold, Jennifer J can be contacted via phone (503) 227-0671.

Contact Information

Primary practice address
2525 Nw Lovejoy St Ste 200 Portland OR 97210-2863
Phone: (503) 227-0671
Fax: (503) 227-0676
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 0900006598N2 Oregon

Profile Details

NPI number 1184620445
LBN Legal business name Siebold, Jennifer J
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2005
Last updated Jul 8th, 2007 - about 19 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 1184620445 NPPES
Oregon MEDICAID 070123

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