Individual
JACOLYN HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2213 COUNTRY CLUB RD, WOODBURN, OR 97071-2811
(503) 982-4200
(503) 981-2323
Mailing address
PO BOX 1114, CANBY, OR 97013-1114
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
348446
OR
225XH1200X
Hand Occupational Therapist
Primary
348446
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500647838
—
OR
Enumeration date
10/09/2015
Last updated
03/02/2019
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