Provider Demographics
NPI:1457134900
Name:SHEERAN, JESSICA LYNDSEY
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNDSEY
Last Name:SHEERAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JESSIE
Other - Middle Name:LYNDSEY
Other - Last Name:SHEERAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:971 SW WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-5651
Mailing Address - Country:US
Mailing Address - Phone:503-640-5297
Mailing Address - Fax:
Practice Address - Street 1:971 SW WALNUT ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-5651
Practice Address - Country:US
Practice Address - Phone:503-640-5297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program