Provider Demographics
NPI:1265628598
Name:RICKMAN, JANET ANN (M S, L P C)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:ANN
Last Name:RICKMAN
Suffix:
Gender:F
Credentials:M S, L P C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11555 JAMES WAY DR SE
Mailing Address - Street 2:
Mailing Address - City:AUMSVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97325-9528
Mailing Address - Country:US
Mailing Address - Phone:503-370-8050
Mailing Address - Fax:503-370-9982
Practice Address - Street 1:565 UNION ST NE STE 100
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-2416
Practice Address - Country:US
Practice Address - Phone:503-370-8050
Practice Address - Fax:503-370-9982
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC 1432101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional