Individual
JEWEL DERIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
111 W C ST, SILVERTON, OR 97381-1458
(503) 873-6111
(503) 873-6113
Mailing address
495 STATE ST, FLOOR 6, SALEM, OR 97301-3757
(503) 400-6110
(503) 400-7956
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0915
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040993
—
OR
Enumeration date
12/05/2005
Last updated
12/31/2013
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