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NPI Code Detail

MEDICARE: MISS JULIE JO CLINE OCCUPATIONAL THERAPI

MEDICARE: MISS JULIE JO CLINE OCCUPATIONAL THERAPI
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
1225XP0200XPediatric Occupational Therapist1070199OR
2225X00000XOccupational Therapist996BDSOR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1029051OTHEROROMAP NUMBER

General Provider Information

NPI Number : 1417048315
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JULIE JO CLINE OCCUPATIONAL THERAPI
Provider Business Mailing Address
First Line : 2125 NE DAGGETT LN
Second Line :
City : BEND
State : OR
Zip : 97701-6560
Country : US
Telephone Number : 541-389-1848
Fax Number : 541-550-7956
Provider Business Practice Location Address
First Line : 60575 BILLADEAU RD
Second Line :
City : BEND
State : OR
Zip : 97702-9338
Country : US
Telephone Number : 541-389-1848
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 03/17/2018

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Directions to “ MISS JULIE JO CLINE OCCUPATIONAL THERAPI” Practice Location

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