Provider Demographics
NPI:1558706622
Name:SHERMAN, JOLYNN M (RN)
Entity Type:Individual
Prefix:
First Name:JOLYNN
Middle Name:M
Last Name:SHERMAN
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 1:9775 SE SUNNYSIDE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-5739
Mailing Address - Country:US
Mailing Address - Phone:503-794-3830
Mailing Address - Fax:503-794-3850
Practice Address - Street 1:9775 SE SUNNYSIDE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-5739
Practice Address - Country:US
Practice Address - Phone:503-794-3830
Practice Address - Fax:503-794-3850
Is Sole Proprietor?:No
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200241623RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse