Provider Demographics
NPI:1215247994
Name:MCCLEERY, JENNIFER HOLLY (PA-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:HOLLY
Last Name:MCCLEERY
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:TURK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1303 NE CUSHING DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-3887
Mailing Address - Country:US
Mailing Address - Phone:541-388-2333
Mailing Address - Fax:541-388-0930
Practice Address - Street 1:2200 NE NEFF RD STE 200
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4281
Practice Address - Country:US
Practice Address - Phone:541-382-3344
Practice Address - Fax:541-382-1681
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA153190363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP01086588OtherMEDICARE RAILROAD
OR500628065Medicaid
ORR156110Medicare PIN