Basic Information
| Provider Information | |||||||||
| NPI: | 1114520590 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOOD | ||||||||
| FirstName: | JONEL | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18773 S NORRY CT | ||||||||
| Address2: | |||||||||
| City: | MULINO | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970429735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4186851345 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2330 DEBOK RD | ||||||||
| Address2: | |||||||||
| City: | WEST LINN | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970683998 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036550474 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/18/2020 | ||||||||
| LastUpdateDate: | 11/18/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 8794 | OR | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.