Jack Lee Otterstrom in Independence - Professional
Jack Lee Otterstrom - NPI 1922163096
Jack Lee Otterstrom is a Professional in Independence, Oregon. Jack Lee Otterstrom practices all healthcare services and medical treatments related to Professional. The NPI Number for Jack Lee Otterstrom is 1922163096. The last update date is 2022-09-06.
Jack Lee Otterstrom's current location address is 656 Jasmine Cir, Independence, Oregon. You can contact this provider via phone number 5412318023. The mailing address for Jack Lee Otterstrom is 656 Jasmine Cir, Independence, Oregon. To know further, please read the information below!
Provider Profile Detail
Provider Name | Jack Lee Otterstrom |
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Address | 656 Jasmine Cir, Independence, Oregon |
Phone Number | 5412318023 |
Fax Number | |
Sole Proprietor | Y |
Credentials | LCSW |
NPI Number Detail
NPI Number | 1922163096 |
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Provider Enumeration Date | 2006-12-27 |
Last Updated Date | 2022-09-06 |
Provider Mailing Address Detail
Address | 656 Jasmine Cir |
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City | Independence |
State | Oregon (OR) |
Post Code | 973519578 |
Phone Number | 5412318023 |
Fax Number |
Provider's Primary Taxonomy Detail
Speciality | Professional |
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Taxonomy | 101Yp2500X |
Licence No | L5316 |
Definition: A general counselor who helps people with personal, social, educational, and career issues. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
R145387 | OR | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Jack Lee Otterstrom by the Centers for Medicare & Medicaid Services (CMS)?
The Jack Lee Otterstrom has been assigned the NPI (National Provider Identifier) 1922163096. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please provide the complete street address where Jack Lee Otterstrom is physically located?
The Jack Lee Otterstrom is physically situated at the following address: 656 Jasmine Cir, Independence, OR, 973519578.
What is Jack Lee Otterstrom's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Jack Lee Otterstrom is Professional, and the taxonomy classification code that categorizes this area of expertise is 101Yp2500X.
On what date did the Centers for Medicare & Medicaid Services assign the 1922163096 to Jack Lee Otterstrom?
The Centers for Medicare & Medicaid Services assigned the 1922163096 to Jack Lee Otterstrom on 2006-12-27.
When was the information pertaining to Jack Lee Otterstrom most recently updated or revised?
The details related to Jack Lee Otterstrom, including its address, specialty, and other relevant information, were last updated or revised on 2022-09-06.