Individual provider · Type 1 NPI
Jennifer K. Shocklie, MSN, RN, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · Portland, OR
NPI number
1265674121
Active
Practice location
5441 S Macadam Ave Ste N
Portland, OR 97239-3822
Fax (541) 512-6127
Other practice locations
- 4539 N 22nd St Ste N, Phoenix, AZ 85016-4639 · (503) 707-1053
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 313153 (AZ) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 10031539 (OR) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1265674121
Jennifer K. Shocklie, MSN, RN, PMHNP-BC's National Provider Identifier is 1265674121, issued on Mar 24, 2009. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Portland, OR. The record was last updated on Jun 24, 2026.