Healthcare Provider Details

I. General information

NPI: 1861799009
Provider Name (Legal Business Name): JACQUENETTE JOCELYN CHAMBERS DNP, ACNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2011
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 SW 105TH AVE
BEAVERTON OR
97008-5468
US

IV. Provider business mailing address

15141 SW LANDON LN
BEAVERTON OR
97006-7128
US

V. Phone/Fax

Practice location:
  • Phone: 503-430-1777
  • Fax:
Mailing address:
  • Phone: 971-463-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License Number201604088
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License Number594010
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License NumberAP60696281
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: