Provider Demographics
NPI:1407203227
Name:BATMALE, JENNIFER ANDREA (PTA, MPH)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANDREA
Last Name:BATMALE
Suffix:
Gender:F
Credentials:PTA, MPH
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ANDREA
Other - Last Name:HESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA, MPH
Mailing Address - Street 1:2520 FEATHER FIRE AVE NW
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-2765
Mailing Address - Country:US
Mailing Address - Phone:503-385-1728
Mailing Address - Fax:
Practice Address - Street 1:3445 BOONE RD SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97317-9336
Practice Address - Country:US
Practice Address - Phone:503-576-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-22
Last Update Date:2016-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR8591225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant