Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 349134 | OR |
N | 225XH1200X | Occupational Therapist - Hand | ||
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | ||
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1932579760 |
---|---|
Provider Name | Rebecca Lynn Jorgensen |
First Address | Portland, OR 97208-3158 |
Second Address | Hood River, OR 97031-2915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2015 |
Last Update Date | 31/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500693978 | (05) | OR |