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1811972912

NPI Code Detail

MEDICARE: JEANINE K WARD OTR/L

MEDICARE: JEANINE K WARD 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
1	225XH1200X	Hand Occupational Therapist	AA395954	OR
2	225XH1200X	Hand Occupational Therapist	OT00000303	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	173185	OTHER	WA	WA L&I

General Provider Information

NPI Number	:	1811972912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANINE K WARD OTR/L

Provider Business Mailing Address
First Line	:	2330 NW FLANDERS ST
Second Line	:	STE G-1
City	:	PORTLAND
State	:	OR
Zip	:	97210-3442
Country	:	US
Telephone Number	:	503-224-9270
Fax Number	:	503-224-9271

Provider Business Practice Location Address
First Line	:	2330 NW FLANDERS ST
Second Line	:	STE G-1
City	:	PORTLAND
State	:	OR
Zip	:	97210-3442
Country	:	US
Telephone Number	:	503-224-9270
Fax Number	:	503-224-9271

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2005
Last Update Date	:	07/09/2007

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Directions to “ JEANINE K WARD OTR/L” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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