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General NPI Number Information
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NPI Number | 1407720691
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Entity Type | Individual
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Provider Name | JIREH PEJANA
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Gender | Male
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Dates
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Enumeration Date | 10/01/2025
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 629 HICKORY ST NW STE 160
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City | ALBANY
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State | OR
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Zip | 97321-1778
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Country | US
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Telephone | 541-730-4655
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1360
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City | PHILOMATH
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State | OR
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Zip | 97370-1360
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 65877
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License Number State | OR
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