Provider Demographics
NPI:1114520590
Name:HOOD, JONEL R (PTA)
Entity Type:Individual
Prefix:
First Name:JONEL
Middle Name:R
Last Name:HOOD
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18773 S NORRY CT
Mailing Address - Street 2:
Mailing Address - City:MULINO
Mailing Address - State:OR
Mailing Address - Zip Code:97042-9735
Mailing Address - Country:US
Mailing Address - Phone:418-685-1345
Mailing Address - Fax:
Practice Address - Street 1:2330 DEBOK RD
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-3998
Practice Address - Country:US
Practice Address - Phone:503-655-0474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR8794208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation