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NPI Code Detail

MEDICARE: JENNIFER JEPSEN OTD/OTR/L

MEDICARE: JENNIFER JEPSEN OTD/OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1316545049
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER JEPSEN OTD/OTR/L
Provider Business Mailing Address
First Line : 3601 26TH PL W APT 422
Second Line :
City : SEATTLE
State : WA
Zip : 98199-2103
Country : US
Telephone Number : 714-872-3733
Fax Number :
Provider Business Practice Location Address
First Line : 2445 3RD AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98134-1923
Country : US
Telephone Number : 714-872-3733
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2020
Last Update Date : 10/14/2020

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