Provider Demographics
NPI:1386806503
Name:ZITOMER, JENNIFER LOIS (RN,BSN; MA)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LOIS
Last Name:ZITOMER
Suffix:
Gender:F
Credentials:RN,BSN; MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16100 SW AUDUBON ST UNIT 103
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-2481
Mailing Address - Country:US
Mailing Address - Phone:503-746-5241
Mailing Address - Fax:
Practice Address - Street 1:16100 SW AUDUBON ST UNIT 103
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-2481
Practice Address - Country:US
Practice Address - Phone:503-746-5241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-29
Last Update Date:2008-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200743220RN163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health