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1376363366 NPI number — JENNIFER OTT MASOTJA-WRIGHT

NPI Number: 1376363366
Health Care Provider/Practitioner: JENNIFER OTT MASOTJA-WRIGHT

Information about “1376363366” NPI (JENNIFER OTT MASOTJA-WRIGHT) exists in 1376363366 in HTML format HTML  |  1376363366 in plain Text format TXT  |  1376363366 in PDF (Portable Document Format) PDF  |  1376363366 in an XML format XML  formats.

NPI Number : 1376363366 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1376363366",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MASOTJA-WRIGHT",
    "FirstName": "JENNIFER",
    "MiddleName": "OTT",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MASOTJA",
    "OtherFirstName": "JENNIFER",
    "OtherMiddleName": "OTT",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "20828 S MATTOON RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ESTACADA",
    "MailingAddressStateName": "OR",
    "MailingAddressPostalCode": "97023-8647",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "541-844-9229",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "20828 S MATTOON RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ESTACADA",
    "PracticeLocationAddressStateName": "OR",
    "PracticeLocationAddressPostalCode": "97023-8647",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "541-844-9229",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/14/2024",
    "LastUpdateDate": "10/14/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": null,
        "LicenseNumberStateCode": "OR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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