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Contact Information

JENNIFER K BANE, PA-C
511 SW 10TH AVE
SUITE 1301
PORTLAND, OR97205-2732
 Phone: 503-228-0155
 Fax: 503-226-8342
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
 

Allergy & Immunology

207K00000X 03 Physician/Allergy/ Immunology
Indicates primary specialty

NPI Profile & details for JENNIFER K BANE · (Female)

NPI Number 1033437298
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 05/12/2010
Last updated 12/13/2019 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • OR License # 173635
  • OR License # PA173635
  • WA License # PA10004564
  • WA Medicaid 2010430
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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