Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 35.125890 | OH |
Y | 207XS0106X | Orthopaedic Hand Surgeon | MD181864 | OR |
NPI | 1639306723 |
---|---|
Provider Name | Jenna Godfrey |
First Address | Eugene, OR 97401-2433 |
Second Address | Eugene, OR 97401-2433 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2009 |
Last Update Date | 03/08/2020 |