Provider Demographics
NPI:1073209144
Name:BARNES, JENNIFER HELEN (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:HELEN
Last Name:BARNES
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16100 NW CORNELL RD # 220
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-7334
Mailing Address - Country:US
Mailing Address - Phone:503-878-8885
Mailing Address - Fax:
Practice Address - Street 1:16100 NW CORNELL RD # 220
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-7334
Practice Address - Country:US
Practice Address - Phone:503-878-8885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR099000617RN163W00000X
ORL-14236163WL0100X
OR10006490363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant