Provider Demographics
NPI:1912240631
Name:SCRIBNER, JENNIFER E (NTP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
Last Name:SCRIBNER
Suffix:
Gender:F
Credentials:NTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 SE 35TH PL
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-5803
Mailing Address - Country:US
Mailing Address - Phone:503-512-6212
Mailing Address - Fax:503-512-6212
Practice Address - Street 1:2011 SE 35TH PL
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-5803
Practice Address - Country:US
Practice Address - Phone:503-512-6212
Practice Address - Fax:503-512-6212
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR001169133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist