Healthcare Provider Details

I. General information

NPI: 1053230318
Provider Name (Legal Business Name): JENNIFER MARIE DOSTERT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 NE BIRCH ST APT 304
CAMAS WA
98607-2010
US

IV. Provider business mailing address

608 NE BIRCH ST APT 304
CAMAS WA
98607-2010
US

V. Phone/Fax

Practice location:
  • Phone: 971-712-6488
  • Fax:
Mailing address:
  • Phone: 971-712-6488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278C0205X
TaxonomyCritical Care Certified Respiratory Therapist
License NumberMASS.MA.70108972
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: