Provider Demographics
NPI:1477857035
Name:CHRISTENSEN, JESSIE ELSA (RN)
Entity Type:Individual
Prefix:
First Name:JESSIE
Middle Name:ELSA
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7668 SW MOHAWK ST
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-8119
Mailing Address - Country:US
Mailing Address - Phone:503-885-5122
Mailing Address - Fax:
Practice Address - Street 1:7668 SW MOHAWK ST
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-8119
Practice Address - Country:US
Practice Address - Phone:503-885-5122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-22
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200542755RN163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management