Individual
JENNIFER ANN FAIRCLOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2804 SW 6TH ST, REDMOND, OR 97756-7143
(541) 312-1963
Mailing address
2804 SW 6TH ST, REDMOND, OR 97756-7143
(541) 312-1963
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1039919
OR
Other
Enumeration date
10/09/2008
Last updated
05/03/2024
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