Provider Demographics
NPI:1982369021
Name:MCNEAL, JENNIFER (ND)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:MCNEAL
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 1:2540 NE MARTIN LUTHER KING JR BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-3732
Mailing Address - Country:US
Mailing Address - Phone:971-220-2759
Mailing Address - Fax:503-954-2250
Practice Address - Street 1:2540 NE MARTIN LUTHER KING JR BLVD STE A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-3732
Practice Address - Country:US
Practice Address - Phone:971-220-2759
Practice Address - Fax:503-954-2250
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC212248171100000X
OR4433175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist