Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 413912 | OR |
NPI | 1245892462 |
---|---|
Provider Name | Dr. Jasmine K Choquette |
First Address | Wilsonville, OR 97070-9697 |
Second Address | Beaverton, OR 97005-4805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2019 |
Last Update Date | 08/07/2019 |