Provider Demographics
NPI:1598934689
Name:JACOBSON-DUNLOP, NATALIE NOEL (MS, CNM)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:NOEL
Last Name:JACOBSON-DUNLOP
Suffix:
Gender:F
Credentials:MS, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 SW SPRING GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-3947
Mailing Address - Country:US
Mailing Address - Phone:503-459-1829
Mailing Address - Fax:
Practice Address - Street 1:9555 SW BARNES RD STE 100
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6668
Practice Address - Country:US
Practice Address - Phone:503-292-3577
Practice Address - Fax:503-292-3947
Is Sole Proprietor?:No
Enumeration Date:2008-02-22
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200850114NP367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife