Provider Demographics
NPI:1629362348
Name:RUTSCHMAN, JANICE MARGARET
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:MARGARET
Last Name:RUTSCHMAN
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 1:1660 OAK ST SE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-6942
Mailing Address - Country:US
Mailing Address - Phone:503-220-8262
Mailing Address - Fax:503-316-9037
Practice Address - Street 1:1660 OAK ST SE
Practice Address - Street 2:SUITE 100
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-6942
Practice Address - Country:US
Practice Address - Phone:503-220-8262
Practice Address - Fax:503-316-9037
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL36961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical