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Jennifer Rost
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NPI Number Detailed Information
Provider Information:
| Name: | Jennifer Rost |
| Gender: | F |
| Provider License Number If Given: | 6942 |
NPI Information:
| NPI: | 1568465508 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 5/23/2005 |
| Last Update Date: | 11/15/2012 |
Provider Business Mailing Address:
| Address: | 16083 SW UPPER BOONES FERRY RD STE. 300 Tigard, OR 97224 |
| Phone Number: | 8002198835 |
| Fax Number: | 5036399699 |
Provider Business Practice Location Address:
| Address: | 2200 NE NEFF RD STE. 202 Bend, OR 97701 |
| Phone Number: | 5413887738 |
| Fax Number: | 5413120121 |
Provider Taxonomy:
| Primary: | 225100000X |
| Secondary (if any): | 225100000X |
| State: | OR |
