Jackson, Jan Leslie

Jackson, Jan Leslie is an individual health care provider with primary practice located at 13470 Sw Farmington Rd , Beaverton OR 97005-2618. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Jackson, Jan Leslie can be contacted via phone (503) 644-3311.

Contact Information

Primary practice address
13470 Sw Farmington Rd Beaverton OR 97005-2618
Fax: (503) 627-0112
Website:

Profile Details

NPI number 1831173251
LBN Legal business name Jackson, Jan Leslie
Credentials PHYSICAL THERAPIST
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Nov 8th, 2007 - about 18 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1831173251 NPPES
Oregon MEDICAID 182799

Popular Providers