Provider Demographics
NPI:1043263650
Name:JASPIN, ROBI MARA (CNM)
Entity Type:Individual
Prefix:MS
First Name:ROBI
Middle Name:MARA
Last Name:JASPIN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MS
Other - First Name:ROBI
Other - Middle Name:MARA
Other - Last Name:QUACKENBUSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:8005 SE TOWHEE CT
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97267-6764
Mailing Address - Country:US
Mailing Address - Phone:503-320-0343
Mailing Address - Fax:
Practice Address - Street 1:8005 SE TOWHEE CT
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97267-6764
Practice Address - Country:US
Practice Address - Phone:503-320-0343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200750009NP367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR271297Medicaid