Provider Demographics
NPI:1558628263
Name:FIRST CALL PAIN MANAGEMENT LLC
Entity Type:Organization
Organization Name:FIRST CALL PAIN MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-371-7246
Mailing Address - Street 1:2608 CASCADIA INDUSTRIAL ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-1159
Mailing Address - Country:US
Mailing Address - Phone:503-371-7246
Mailing Address - Fax:503-576-2634
Practice Address - Street 1:2608 CASCADIA INDUSTRIAL ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-1159
Practice Address - Country:US
Practice Address - Phone:503-371-7246
Practice Address - Fax:503-576-2634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR238234225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty