Provider Demographics
NPI:1952654550
Name:FORD, JALEEN LYNN (MSN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JALEEN
Middle Name:LYNN
Last Name:FORD
Suffix:
Gender:F
Credentials:MSN, FNP-C
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Other - First Name:
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Mailing Address - Street 1:12725 SW MILLIKAN WAY STE 300
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-1687
Mailing Address - Country:US
Mailing Address - Phone:971-998-9747
Mailing Address - Fax:503-747-0634
Practice Address - Street 1:12725 SW MILLIKAN WAY STE 300
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-1687
Practice Address - Country:US
Practice Address - Phone:971-998-9747
Practice Address - Fax:503-747-0634
Is Sole Proprietor?:No
Enumeration Date:2012-10-19
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR201407547NP-PP363LF0000X, 363LP2300X
NC131489363LF0000X
AZ290613363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care