| NPI | 1326458753 |
|---|---|
| Former Name | JESSICA MARIE BERQUIST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201801007NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201800903RN) |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2022-03-01 |