Provider Demographics
NPI:1326026758
Name:COX, JEFFREY DANIEL (PT, DPT, OCS)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:DANIEL
Last Name:COX
Suffix:
Gender:M
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 592
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-0592
Mailing Address - Country:US
Mailing Address - Phone:503-723-0347
Mailing Address - Fax:503-655-9305
Practice Address - Street 1:1554 GARDEN ST STE 103
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-3278
Practice Address - Country:US
Practice Address - Phone:503-723-0347
Practice Address - Fax:503-655-9305
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OROR4764225100000X
CO8230225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR022779Medicaid
OR825473007OtherREGENCE PPO
OR300622007OtherREGENCE ADVANTAGE & PREFE
OR825473007OtherREGENCE PPO