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NPI Code Detail

MEDICARE: JILLIAN MARCUCCI M.A.

MEDICARE: JILLIAN MARCUCCI M.A.
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 Therapist451605OR
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1922625904
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILLIAN MARCUCCI M.A.
Provider Business Mailing Address
First Line : 2577 NE COURTNEY DR
Second Line :
City : BEND
State : OR
Zip : 97701-7752
Country : US
Telephone Number : 541-322-7500
Fax Number : 541-322-7565
Provider Business Practice Location Address
First Line : 63311 JAMISON ST
Second Line :
City : BEND
State : OR
Zip : 97703-8288
Country : US
Telephone Number : 541-322-7500
Fax Number : 541-322-7565
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2020
Last Update Date : 12/16/2025

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