NPI 1194147454

Jack Robert Lennon, EMTB

Practitioner Basic Emergency Medical Technician Portland, OR

Practice location

Address: 1535 N Williams Ave, Portland, OR 97227-1885
Phone: (503) 238-2067
Mailing address: 232 NW 6th Ave, Portland, OR 97209-3609

Registered specialties

Basic Emergency Medical Technician Primary

Emergency Medical Service Providers Taxonomy 146N00000X Licence 138276 (OR)

Other Emergency Medical Technician, Basic providers in Oregon →

Registry record

NPI: 1194147454
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Jan 2014
Record last updated: 6 Jan 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.