NPI 1699445874 · live from the CMS NPI Registry
Christy Jacobo, RN
Registered Nurse, Gerontology in Portland, OR. National Provider Identifier 1699445874, active.
NPI record
| NPI | 1699445874 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Registered Nurse, Gerontology 163WG0600X |
| Practice location | 11050 Se Cherry Blossom Dr, Portland, OR 97216 |
| Practice phone | 702-773-7869 |
| Enumerated | September 17, 2021 |
| Last updated | September 17, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, Gerontology primary | 163WG0600X | 201608791RN (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.