Provider Demographics
NPI:1760685085
Name:BARNES, JEAN H (MOT)
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:H
Last Name:BARNES
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:
Other - Last Name:HILLIARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT
Mailing Address - Street 1:PO BOX 2485
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-0660
Mailing Address - Country:US
Mailing Address - Phone:503-491-1666
Mailing Address - Fax:503-491-1667
Practice Address - Street 1:24076 SE STARK ST
Practice Address - Street 2:SUITE 200
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-3373
Practice Address - Country:US
Practice Address - Phone:503-491-1666
Practice Address - Fax:503-491-1667
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR368126225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR368126OtherO.T. LICENSE