Staubach, Jesse C

Staubach, Jesse C is an individual health care provider with primary practice located at 320 Central Ave Ste 304 , Coos Bay OR 97420-2241. He recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as his primary health care specialty. Staubach, Jesse C can be contacted via phone (541) 366-7640.

Contact Information

Primary practice address
320 Central Ave Ste 304 Coos Bay OR 97420-2241
Phone: (541) 366-7640
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X THW000003807 Oregon

Profile Details

NPI number 1114560802
LBN Legal business name Staubach, Jesse C
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2019
Last updated Oct 24th, 2019 - about 6 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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