MRS. JACQUELYN ALICE BENNETT RN
NPI 1083964704
Registered Nurse - Gerontology in Portland, OR

Active since September 11, 2012
4540 NE GLISAN ST, PORTLAND, OR 97213(503) 215-3738 Get Directions Write a Review

NPPES record last updated: September 11, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Jacquelyn Alice Bennett Rn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. JACQUELYN ALICE BENNETT RN (NPI 1083964704) is an individual gerontology provider in Portland, Oregon, licensed in Oregon (200340760RN) and active in the NPI registry since September 2012.

NPPES Registry Identity

NPI1083964704
Entity TypeIndividualFemale
Primary Taxonomy163WG0600X
Provider Legal NameMRS. JACQUELYN ALICE BENNETTCredential: RN
Location Address4540 NE GLISAN STPortland, OR 97213-2333
Mailing Address4540 Ne Glisan StPortland, OR 97213-2333 · (503) 215-3738
Sole ProprietorNo
Enumeration DateSeptember 11, 2012
NPI 1083964704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyRegistered Nurse · GerontologyNursing Service Providers
Taxonomy Code163WG0600X
License Licensed in OR · 200340760RN
4540 NE GLISAN ST, Portland, OR 97213

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Multi-Specialty)
4540 NE GLISAN ST
PORTLAND, OR 97213
Registered Nurse (Community Health)
4540 NE GLISAN ST
PORTLAND, OR 97213
Registered Nurse
4540 NE GLISAN ST
PORTLAND, OR 97213
Registered Nurse
4540 NE GLISAN ST
PORTLAND, OR 97213
Dietitian, Registered
4540 NE GLISAN ST
PORTLAND, OR 97213
Registered Nurse (Community Health)
4540 NE GLISAN ST
PORTLAND, OR 97213
Registered Nurse
4540 NE GLISAN ST
PORTLAND, OR 97213
Registered Nurse (Case Management)
4540 NE GLISAN ST
PORTLAND, OR 97213

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacquelyn Bennett's NPI number?

The NPI number for Jacquelyn Bennett is 1083964704. It was assigned to this individual provider in the NPPES registry on September 11, 2012.

Where is Jacquelyn Bennett located?

Jacquelyn Bennett practices at 4540 NE Glisan St, Portland, OR 97213. The listed phone number is (503) 215-3738.

What is Jacquelyn Bennett's specialty?

The primary specialty registered for this NPI is Registered Nurse, specializing in Gerontology, with taxonomy code 163WG0600X.

When was this NPI record last updated?

The NPPES record for Jacquelyn Bennett was last updated on September 11, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.