Provider Demographics
NPI:1740416726
Name:COCORES, JILL LINMAN (OTR)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:LINMAN
Last Name:COCORES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 NW GREYHAWK AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-5607
Mailing Address - Country:US
Mailing Address - Phone:541-383-9026
Mailing Address - Fax:
Practice Address - Street 1:526 NW GREYHAWK AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-5607
Practice Address - Country:US
Practice Address - Phone:541-383-9026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR86773174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist