Green, Jeff C

Green, Jeff C is an individual health care provider with primary practice located at 200 Gwee Shut Rd , Siletz OR 97380-2036. He recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as his primary health care specialty. Green, Jeff C can be contacted via phone (541) 444-9613.

Contact Information

Primary practice address
200 Gwee Shut Rd Siletz OR 97380-2036
Phone: (541) 444-9613
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X 8371309 Oregon

Profile Details

NPI number 1053059352
LBN Legal business name Green, Jeff C
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2022
Last updated May 25th, 2022 - about 3 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 1053059352 NPPES
Oregon MEDICAID 8989

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