Takaesu, Jean M

Takaesu, Jean M is an individual health care provider with primary practice located at 7101 Ne 137Th Ave , Vancouver WA 98682-4933. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand, which is considered as her primary health care specialty. Takaesu, Jean M can be contacted via phone (360) 944-4988.

Contact Information

Primary practice address
7101 Ne 137Th Ave Vancouver WA 98682-4933
Phone: (360) 944-4988
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand 225XH1200X OT00003054 Washington
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand 225XH1200X 1031035 Oregon

Profile Details

NPI number 1700861804
LBN Legal business name Takaesu, Jean M
Credentials OTR/L
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2005
Last updated Dec 30th, 2021 - 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 1700861804 NPPES
Oregon Other 098565024 BCBSO
Oregon Other 0199636 BCBSO
Oregon MEDICAID 8434631 BCBSO
Oregon MEDICAID 269899 BCBSO

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