Healthcare Provider Details

I. General information

NPI: 1376883488
Provider Name (Legal Business Name): JENNIFER DYANN ROBBLEE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2013
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 OAK ST SE STE 4030
SALEM OR
97301-3984
US

IV. Provider business mailing address

5285 ANACONDA DR S
SALEM OR
97302-9434
US

V. Phone/Fax

Practice location:
  • Phone: 503-561-6444
  • Fax: 503-561-6440
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number10063390
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: