Provider Demographics
NPI:1841315926
Name:STAGER, JENNIFER LOU (FNP ARNP RN MS)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LOU
Last Name:STAGER
Suffix:
Gender:F
Credentials:FNP ARNP RN MS
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LOU
Other - Last Name:ARTHUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4640 FRAZIER DR
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031
Mailing Address - Country:US
Mailing Address - Phone:541-386-3414
Mailing Address - Fax:
Practice Address - Street 1:1630 WOODS CT
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031
Practice Address - Country:US
Practice Address - Phone:541-387-6449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003678363LF0000X
OR363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9624STOtherREGENCE
WA9615519Medicaid
WA9620STOtherREGENCE
WA9624STOtherREGENCE