Individual
JENNIFER KEARSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
51577 COLUMBIA RIVER HWY STE A, SCAPPOOSE, OR 97056-8409
(503) 543-0254
(503) 543-0259
Mailing address
16083 SW UPPER BOONES FERRY RD STE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60759
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0330024
WA L&I
OR
01
—
0330029
WA L&I
OR
05
—
500675880
—
OR
01
—
P01457340
RR MEDICARE PTAN
OR
Enumeration date
08/20/2014
Last updated
05/07/2018
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