Individual
JAN STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2411 9TH ST, TILLAMOOK, OR 97141-4015
(503) 842-1259
(503) 842-8538
Mailing address
2411 9TH ST, TILLAMOOK, OR 97141-4015
(503) 842-1259
(503) 842-8538
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
507204
OR
172V00000X
Community Health Worker
Primary
507204
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
507204
—
OR
Enumeration date
04/14/2014
Last updated
04/14/2014
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