Provider Demographics
NPI:1841344439
Name:THOMAN, JENNIFER (ND)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:THOMAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:ELIZABETH
Other - Last Name:THOMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ND
Mailing Address - Street 1:2406 SE 60TH AVE
Mailing Address - Street 2:SUIRE 202
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206
Mailing Address - Country:US
Mailing Address - Phone:503-457-7799
Mailing Address - Fax:866-571-9631
Practice Address - Street 1:2406 SE 60TH AVE
Practice Address - Street 2:SUIRE 202
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206
Practice Address - Country:US
Practice Address - Phone:503-457-7799
Practice Address - Fax:866-571-9631
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1477175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath