Individual provider · Type 1 NPI
Jennifer Botelho, PA-C
Surgical Physician Assistant · Portland, OR
NPI number
1891782751
Active
Practice location
1130 NW 22nd Ave Ste 535
Portland, OR 97210-2976
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | PA00838 (OR) |
Surgical Physician Assistant: Definition to come...
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About NPI 1891782751
Jennifer Botelho, PA-C's National Provider Identifier is 1891782751, issued on Oct 5, 2005. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Portland, OR. The record was last updated on Aug 26, 2011.