Smith, Jenna
Smith, Jenna is an individual health care provider with primary practice located at 9290 Se Sunnybrook Blvd Ste 120 , Clackamas OR 97015-6802. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Smith, Jenna can be contacted via phone (503) 215-2110.Contact Information
Primary practice address
9290 Se Sunnybrook Blvd Ste 120
Clackamas OR 97015-6802
Phone: (503) 215-2110
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 0110003673 | Virginia |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA165997 | Oregon |
Profile Details
| NPI number | 1558645812 |
|---|---|
| LBN Legal business name | Smith, Jenna |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 5th, 2011 |
| Last updated | Sep 15th, 2021 - about 4 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 | 1558645812 | NPPES |
| Oregon | MEDICAID | 500669843 |
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