Provider Demographics
NPI:1134379928
Name:CUYLER, JEAN HABECKER (RADIOLOGIC TECH)
Entity type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:HABECKER
Last Name:CUYLER
Suffix:
Gender:F
Credentials:RADIOLOGIC TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30695 NW NORTHRUP RD
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINS
Mailing Address - State:OR
Mailing Address - Zip Code:97133-8405
Mailing Address - Country:US
Mailing Address - Phone:503-647-5132
Mailing Address - Fax:
Practice Address - Street 1:30695 NW NORTHRUP RD
Practice Address - Street 2:
Practice Address - City:NORTH PLAINS
Practice Address - State:OR
Practice Address - Zip Code:97133-8405
Practice Address - Country:US
Practice Address - Phone:503-647-5132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1071912471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography