Provider Demographics
NPI:1376141150
Name:JEWELL, HILLARY LIND
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:LIND
Last Name:JEWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 EXECUTIVE PKWY STE 360
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2169
Mailing Address - Country:US
Mailing Address - Phone:541-515-0350
Mailing Address - Fax:541-683-8610
Practice Address - Street 1:10 COBURG RD STE 300
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7481
Practice Address - Country:US
Practice Address - Phone:541-683-3234
Practice Address - Fax:541-683-8610
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11885174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist