Basic Information
| Provider Information | |||||||||
| NPI: | 1518165323 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOMLINSON | ||||||||
| FirstName: | JILL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2065 NW HILL ST | ||||||||
| Address2: | APT C | ||||||||
| City: | BEND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 977011336 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5413184845 | ||||||||
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| Practice Location | |||||||||
| Address1: | 63360 NW BRITTA ST | ||||||||
| Address2: | BLDG 1 | ||||||||
| City: | BEND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 977016869 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5413184845 | ||||||||
| FaxNumber: | 5413185156 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.