Healthcare Provider Details

I. General information

NPI: 1629404041
Provider Name (Legal Business Name): JOYCE MARIE SJOBERG RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NONE JS RN CONSULTING, LLC MA, RN

II. Dates (important events)

Enumeration Date: 09/17/2013
Last Update Date: 09/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 SW COLONY DR
PORTLAND OR
97219-7763
US

IV. Provider business mailing address

PO BOX 1264 19190 SW 90TH AVE.
TUALATIN OR
97062-1264
US

V. Phone/Fax

Practice location:
  • Phone: 503-780-1482
  • Fax:
Mailing address:
  • Phone: 503-780-1482
  • Fax: 503-235-4616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00081843
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: