Jacque Long

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

09396 Issued in OR

Practice address

315 Oak St
Suite 200
Hood River, OR 97031-2062

Phone

(541) 386-0009

NPI assigned

Dec 13, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kidsense Inc

  • Occupational Therapist
  • Hood River, OR
  • NPI 1902087901
  NPD (past)
• Kidsense Inc.

  • Pediatric Physical Therapist
  • Hood River, OR
  • NPI 1992979272
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1821532631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 OAK ST",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970312062",
            "telephone_number": "541-386-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 OAK ST",
            "address_2": "SUITE 200",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970312062",
            "telephone_number": "541-386-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "JACQUE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-13",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OR",
            "license": "09396",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160660710",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Torie Joan Lindskog, PMHNP
• Little Shredders Dental
• Lee Samler Lloyd, D.C.
• Dana Lockhart, ND, MSOM, LAC
• Abigail Loihl
• Ann Loomis
• Adelina Lopez, CADC I
• Charalla Dee Lopez, LMT, MMP
• Constantino Lopez, CADC
• Aaron M Loyd, MD

• Physical Therapy Assistant in Hood River, OR
• Providers in Hood River, OR by specialty
• Physical Therapy Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.