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General NPI Number Information
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NPI Number | 1457224313
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Entity Type | Individual
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Provider Name | JESSIE MARTIN CARRIGAN OTR
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Gender | Male
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Dates
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Enumeration Date | 09/26/2025
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 2611 PRINGLE RD SE
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City | SALEM
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State | OR
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Zip | 97302-1533
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Country | US
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Telephone | 503-588-5330
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Fax |
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Provider Business Mailing Address
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Address Line | 1924 FENNER GLEN DR
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City | MUSKEGON
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State | MI
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Zip | 49445-3513
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Country | US
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Telephone | 231-720-8810
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 520864
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License Number State | OR
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