Jennifer S Mitchell, PA-C
Physician Assistant in Portland, OR. Individual provider (NPI-1).
NPI number1609019686
StatusActive
Last updated in NPPESDec 21, 2020
Details
- NPI
- 1609019686
- Entity type
- Individual (NPI-1)
- Name
- Jennifer S Mitchell
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 7, 2009
- Certification date
- Dec 21, 2020
- Last updated
- Dec 21, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA153534 | OR | Yes |
| 363AM0700X | Physician Assistant, Medical | PA153534 | OR |
Practice location
4411 Sw Vermont StPortland, OR 97219-1020
Phone 503-494-9992 · Fax 503-494-9196
Mailing address
4411 Sw Vermont StPortland, OR 97219-1020
Phone 503-494-9992 · Fax 503-494-9196
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