Carley, Jennifer

Carley, Jennifer is an sole proprietor health care provider with primary practice located at 4035 12Th St Cutoff Se Ste 120 , Salem OR 97302-1754. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Carley, Jennifer can be contacted via phone (503) 371-3121.

Contact Information

Primary practice address
4035 12Th St Cutoff Se Ste 120 Salem OR 97302-1754
Phone: (503) 371-3121
Fax: (503) 315-7571
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 200250038NP PMHNP PP Oregon

Profile Details

NPI number 1114918471
LBN Legal business name Carley, Jennifer
Credentials PMHNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 3rd, 2005
Last updated May 4th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114918471 NPPES
Oregon Other 731653143 BUSINESS TAX ID
Oregon Other 807992000 BUSINESS TAX ID

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