Healthcare Provider Details

I. General information

NPI: 1881739100
Provider Name (Legal Business Name): JASON MICHAEL DUNN RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 NW 18TH AVE
PORTLAND OR
97209-2516
US

IV. Provider business mailing address

21590 NE LAUREL WOOD LN
FAIRVIEW OR
97024-6796
US

V. Phone/Fax

Practice location:
  • Phone: 503-542-4888
  • Fax:
Mailing address:
  • Phone: 503-320-9516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number200341634RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: