Provider Demographics
NPI:1235674136
Name:BREATHE EASY WITH JENN, PC
Entity Type:Organization
Organization Name:BREATHE EASY WITH JENN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:971-301-8309
Mailing Address - Street 1:3000 MARKET ST NE STE 541
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-1835
Mailing Address - Country:US
Mailing Address - Phone:971-301-8309
Mailing Address - Fax:971-301-8310
Practice Address - Street 1:3000 MARKET ST NE STE 541
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-1835
Practice Address - Country:US
Practice Address - Phone:971-301-8309
Practice Address - Fax:971-301-8310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-30
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRT-P-10135828261QH0100X, 261QR0401X
261QM1300X, 261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic