DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JESSIKA FATU

Active Sole Proprietor

Community Health Center · PORTLAND, OR

Registration Details

NPI Number
1366018343
Provider Type
Individual
Gender
Female
NPI Issued
Jun 1, 2021 (4.9168857524264 yrs)
Last Updated
Jun 1, 2021
Sole Proprietor
Yes

Practice Information

Address
6736 NE KILLINGSWORTH ST
PORTLAND, OR, 972183338
Browse OR providers · Browse ZIP 97218
Phone
5033513955
Primary Specialty
Community Health Center
261QC1500X

Other Community Health Center Providers in PORTLAND, OR

Name Credential NPI
SARA STANCZAK 1972271427
ARETHA DEANN STONE 1639806292
MITCHELL S BRANCH CRM 1063128916
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.