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General NPI Number Information
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NPI Number | 1457160640
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Entity Type | Individual
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Provider Name | JENNIFER L SPEZZA MS, FNP-C, CWOCN
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Gender | Female
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Dates
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Enumeration Date | 01/02/2025
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Last Update Date | 09/02/2026
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Provider Practice Location Address
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Address Line | 6410 NE HALSEY ST
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City | PORTLAND
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State | OR
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Zip | 97213-4742
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Country | US
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Telephone | 503-215-4646
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Fax |
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Provider Business Mailing Address
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Address Line | 14954 SE EL CAMINO WAY
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City | MILWAUKIE
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State | OR
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Zip | 97267-3134
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Country | US
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Telephone | 503-679-6833
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 10056675
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 70120775
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN61507618
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 200340775RN
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License Number State | OR
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