=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639098239
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOVANA PAZIN DPT, PT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/15/2026
-----------------------------------------------------
Last Update Date | 07/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1750 WILCO RD
-----------------------------------------------------
City | STAYTON
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97383-1085
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-769-7131
-----------------------------------------------------
Fax | 503-769-7132
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3400 STATE ST STE G780
-----------------------------------------------------
City | SALEM
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97301-7015
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-769-7131
-----------------------------------------------------
Fax | 503-769-7132
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 66124
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------