Provider Demographics
NPI:1609015049
Name:QUIRING, JASON (PHD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:QUIRING
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 PINE FOREST DR
Mailing Address - Street 2:PO BOX 5585
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-4070
Mailing Address - Country:US
Mailing Address - Phone:503-702-9218
Mailing Address - Fax:
Practice Address - Street 1:895 PINE FOREST DR
Practice Address - Street 2:BOX 5585
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-4070
Practice Address - Country:US
Practice Address - Phone:503-702-9218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1707103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical