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NPI Code Detail

MEDICARE: MS. HANNAH KATHLEEN JAEGER

MEDICARE: MS. HANNAH KATHLEEN JAEGER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1417811571
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. HANNAH KATHLEEN JAEGER
Provider Business Mailing Address
First Line : 3181 SW SAM JACKSON PARK RD
Second Line :
City : PORTLAND
State : OR
Zip : 97239-3011
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3181 SW SAM JACKSON PARK RD
Second Line :
City : PORTLAND
State : OR
Zip : 97239-3011
Country : US
Telephone Number : 503-494-8311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2025
Last Update Date : 12/12/2025

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