Provider Demographics
NPI:1508127986
Name:ALBERI, JAE (LMT)
Entity Type:Individual
Prefix:
First Name:JAE
Middle Name:
Last Name:ALBERI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-2358
Mailing Address - Country:US
Mailing Address - Phone:503-729-3275
Mailing Address - Fax:
Practice Address - Street 1:302 MONROE ST
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-2358
Practice Address - Country:US
Practice Address - Phone:503-729-3275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-02
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19114174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist