Jessie Clausen, PTA

Individual provider Active NPI Physical Therapy Assistant · Veneta, OR

NPI 1891242871 · NPPES record last updated Sep 7, 2016

Key facts

NPI
1891242871
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
09361 (OR)
Practice address
88267 Territorial Rd
Suite 10a
Veneta, OR 97487-9499
Phone
(541) 935-0761
Fax
(541) 935-0536
NPI assigned
Sep 7, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
09361ORMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Life Force Physical Therapy, Inc Past
since Jan 1, 2015
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 09361 OR Yes

Addresses

Primary practice location

88267 Territorial Rd
Suite 10a
Veneta, OR 97487-9499

Mailing address

12705 Village Loop Rd
Swisshome, OR 97480
Phone (541) 297-2705

Other providers in Veneta, OR

All providers in Veneta, OR · Physical Therapy Assistant in Oregon

Sources for this page

Verify at the official NPI Registry.