1295062263 NPI number — JENNIFER L HUGHES DPT

Table of content: MRS. BERNADETTE JOYCE MEJIA M.S., R.D. (NPI 1528305158)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295062263 NPI number — JENNIFER L HUGHES DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUGHES
Provider First Name:
JENNIFER
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295062263
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1517
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PENDLETON
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97801-0410
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-708-1119
Provider Business Mailing Address Fax Number:
541-278-8349

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ALPINE PHYSICAL THERAPY
Provider Second Line Business Practice Location Address:
336 SW CYBER DR. SUITE 107
Provider Business Practice Location Address City Name:
BEND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-382-5500
Provider Business Practice Location Address Fax Number:
541-389-5669
Provider Enumeration Date:
11/11/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  6114 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)