Healthcare Provider Details

I. General information

NPI: 1841672011
Provider Name (Legal Business Name): JENNIFER LYN OSTRICK CRONRATH FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER OSTRICK FNP-C

II. Dates (important events)

Enumeration Date: 06/24/2015
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5441 S MACADAM AVE STE 5262
PORTLAND OR
97239-3822
US

IV. Provider business mailing address

PO BOX 3007
PORTLAND OR
97208-3007
US

V. Phone/Fax

Practice location:
  • Phone: 503-610-2066
  • Fax: 503-447-6416
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10049644
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: