Individual
JENNIFER ANN SLATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
16639 BOX WAY, SUITE A, LA PINE, OR 97739
(541) 536-7515
Mailing address
16060 WRIGHT AVE, LA PINE, OR 97739-9756
(541) 610-6355
(541) 536-3170
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
LMT 14772
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
613539800
OWCP U.S. DEPT. OF LABOR
OR
Enumeration date
12/09/2008
Last updated
12/09/2008
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