Lietzke, Jennifer Anne
Lietzke, Jennifer Anne is an individual health care provider with primary practice located at 2935 Sw Cedar Hills Blvd , Beaverton OR 97005-1342. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Lietzke, Jennifer Anne can be contacted via phone (503) 352-6000.Contact Information
Primary practice address
2935 Sw Cedar Hills Blvd
Beaverton OR 97005-1342
Phone: (503) 352-6000
Fax: (503) 352-6080
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD28993 | Oregon |
Profile Details
| NPI number | 1699701631 |
|---|---|
| LBN Legal business name | Lietzke, Jennifer Anne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 23rd, 2006 |
| Last updated | Feb 6th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699701631 | NPPES |
| Oregon | MEDICAID | 500634215 |
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