Provider Demographics
NPI:1366628505
Name:FERRER, JAMES L
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:L
Last Name:FERRER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 E 19TH ST
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-3385
Mailing Address - Country:US
Mailing Address - Phone:541-298-8676
Mailing Address - Fax:541-298-7746
Practice Address - Street 1:1815 E 19TH ST
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-3385
Practice Address - Country:US
Practice Address - Phone:541-298-8676
Practice Address - Fax:541-298-7746
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORHASP322112237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR159731Medicaid
WA93231OtherLABOR & INDUSTRIES
WA9464702Medicaid