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General NPI Number Information
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NPI Number | 1326056847
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Entity Type | Individual
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Provider Name | JENNIFER ELIZABETH BEVACQUA NP
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Gender | Female
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 335 SE 8TH AVE
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City | HILLSBORO
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State | OR
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Zip | 97123-4246
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Country | US
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Telephone | 503-681-1860
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Fax |
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Provider Business Mailing Address
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Address Line | 335 SE 8TH AVE
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City | HILLSBORO
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State | OR
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Zip | 97123-4246
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Country | US
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Telephone | 503-681-1860
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Fax |
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 200550067NP
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | AP60821940
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 200550067NP
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 200041072RN
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License Number State | OR
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