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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

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