Individual
MS. JEANNE ELLEN HAISLIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
730 FOOTHILLS DR, NEWBERG, OR 97132-6004
(503) 554-0767
Mailing address
25117 SW PARKWAY AVE, SUITE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1006441
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200072540A
DDS DHS
OK
01
—
200072540B
NON-FED MED
OK
Enumeration date
11/01/2006
Last updated
03/28/2013
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