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General NPI Number Information
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NPI Number | 1265373690
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Entity Type | Individual
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Provider Name | JESS P HENKE
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Gender | Male
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Dates
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Enumeration Date | 04/01/2026
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Last Update Date | 04/01/2026
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Provider Practice Location Address
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Address Line | 815 S NEHALEM ST
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City | CLATSKANIE
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State | OR
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Zip | 97016-2852
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Country | US
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Telephone | 503-728-2191
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Fax | 503-728-2840
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Provider Business Mailing Address
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Address Line | PO BOX 678
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City | CLATSKANIE
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State | OR
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Zip | 97016-0678
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Country | US
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Telephone | 503-728-0587
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Fax | 503-728-0608
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 10026402
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License Number State | OR
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