Provider Demographics
NPI:1003074238
Name:JEFFREY, JAMILYN D (RPT)
Entity Type:Individual
Prefix:MS
First Name:JAMILYN
Middle Name:D
Last Name:JEFFREY
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:MS
Other - First Name:JAMILYN
Other - Middle Name:D
Other - Last Name:WENBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4560 SE INTERNATIONAL WAY SUITE 100
Mailing Address - Street 2:CONSONUS HEALTHCARE SERVICES
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222
Mailing Address - Country:US
Mailing Address - Phone:971-206-5149
Mailing Address - Fax:971-206-5209
Practice Address - Street 1:4560 SE INTERNATIONAL WAY SUITE 100
Practice Address - Street 2:CONSONUS HEALTHCARE SERVICES
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222
Practice Address - Country:US
Practice Address - Phone:971-206-5149
Practice Address - Fax:971-206-5209
Is Sole Proprietor?:No
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28728225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist