Provider Demographics
NPI:1508612953
Name:CHANCE, JEAN 'JEANNIE' MAUREEN
Entity Type:Individual
Prefix:
First Name:JEAN 'JEANNIE'
Middle Name:MAUREEN
Last Name:CHANCE
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 1:1011 EUGENE ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1415
Mailing Address - Country:US
Mailing Address - Phone:541-386-2511
Mailing Address - Fax:
Practice Address - Street 1:1001 10TH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1593
Practice Address - Country:US
Practice Address - Phone:541-386-2656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist