Provider Demographics
NPI:1346408135
Name:CHEN, JENNIFER (ND, RPH)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:ND, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1926 W BURNSIDE ST
Mailing Address - Street 2:UNIT #1201
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-2066
Mailing Address - Country:US
Mailing Address - Phone:503-913-3627
Mailing Address - Fax:
Practice Address - Street 1:1926 W BURNSIDE ST
Practice Address - Street 2:UNIT #1201
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-2066
Practice Address - Country:US
Practice Address - Phone:503-913-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1489175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath