Healthcare Provider Details

I. General information

NPI: 1740740455
Provider Name (Legal Business Name): LORI ANN JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 03/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82B CENTENNIAL LOOP
EUGENE OR
97401-7909
US

IV. Provider business mailing address

2145 CENTENNIAL PLZ
EUGENE OR
97401-2421
US

V. Phone/Fax

Practice location:
  • Phone: 541-684-6820
  • Fax: 541-345-9218
Mailing address:
  • Phone: 541-684-6820
  • Fax: 541-345-9218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: