Basic Information
| Provider Information | |||||||||
| NPI: | 1538882105 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BELLINGER | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | PATRICIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 440 E 32ND AVE | ||||||||
| Address2: | |||||||||
| City: | EUGENE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974053759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8057056786 | ||||||||
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| Practice Location | |||||||||
| Address1: | 960 N 16TH ST STE 104 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974774175 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417448660 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2022 | ||||||||
| LastUpdateDate: | 09/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.