Provider Demographics
NPI:1649869850
Name:DOKE-MAGRUDER, JILLIAN (NP)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:DOKE-MAGRUDER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 NE PENN AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4255
Mailing Address - Country:US
Mailing Address - Phone:541-854-3175
Mailing Address - Fax:877-259-3041
Practice Address - Street 1:180 NE PENN AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4255
Practice Address - Country:US
Practice Address - Phone:541-854-3175
Practice Address - Fax:877-259-3041
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-12
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202102226NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily