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General NPI Number Information
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NPI Number | 1235674136
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Entity Type | Organization
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Legal Business Name | BREATHE EASY WITH JENN, PC
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Dates
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Enumeration Date | 12/30/2016
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Last Update Date | 01/26/2018
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Provider Practice Location Address
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Address Line | 3000 MARKET ST NE STE 541
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City | SALEM
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State | OR
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Zip | 97301-1835
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Country | US
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Telephone | 971-301-8309
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Fax | 971-301-8310
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Provider Business Mailing Address
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Address Line | 3000 MARKET ST NE STE 541
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City | SALEM
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State | OR
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Zip | 97301-1835
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Country | US
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Telephone | 971-301-8309
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Fax | 971-301-8310
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | JENNIFER LYNN BALDWIN
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Credential | RRT
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Telephone | 971-301-8309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number | RT-P-10135828
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | RT-P-10135828
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License Number State | OR
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