Provider Demographics
NPI:1609901230
Name:TUFENKIAN, JENNIFER SUZANNE (ND)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:SUZANNE
Last Name:TUFENKIAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4110 SE HAWTHORNE BLVD
Mailing Address - Street 2:#629
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-4026
Mailing Address - Country:US
Mailing Address - Phone:503-894-9677
Mailing Address - Fax:833-315-1018
Practice Address - Street 1:4110 SE HAWTHORNE BLVD
Practice Address - Street 2:#629
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-4026
Practice Address - Country:US
Practice Address - Phone:503-894-9677
Practice Address - Fax:833-315-1018
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1053175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath