Healthcare Provider Details

I. General information

NPI: 1306773783
Provider Name (Legal Business Name): JENNIFER HUNT-PETRAK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61555 PARRELL RD
BEND OR
97702-2701
US

IV. Provider business mailing address

18943 BAKER RD
BEND OR
97702-7917
US

V. Phone/Fax

Practice location:
  • Phone: 541-318-1000
  • Fax: 541-318-7050
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: