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General NPI Number Information
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NPI Number | 1407868805
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Entity Type | Individual
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Provider Name | JENNIFER ERIN BRAY F.N.P.
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Gender | Female
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 6400 SE LAKE RD STE 155
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City | PORTLAND
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State | OR
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Zip | 97222-2137
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Country | US
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Telephone | 503-447-3285
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Fax | 503-917-4971
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Provider Business Mailing Address
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Address Line | 6400 SE LAKE RD STE 430
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City | PORTLAND
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State | OR
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Zip | 97222-2129
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Country | US
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Telephone | 971-358-9292
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Fax | 503-917-4971
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 200250088NP-FNP-PP
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License Number State | OR
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