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NPI Code Detail

MEDICARE: JESSIE FOSTER

MEDICARE: JESSIE FOSTER
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
1163W00000XRegistered NurseRN61571164WA

General Provider Information

NPI Number : 1417814179
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSIE FOSTER
Provider Business Mailing Address
First Line : 15203 NE 81ST WAY
Second Line :
City : VANCOUVER
State : WA
Zip : 98682-3493
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1015 NW 22ND AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97210-3025
Country : US
Telephone Number : 503-413-7711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2026
Last Update Date : 01/06/2026

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Directions to “ JESSIE FOSTER ” Practice Location

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