Basic Information
Provider Information
NPI: 1689734360
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DELANEY
FirstName: JENNIFER
MiddleName: MAE
NamePrefix: MRS.
NameSuffix:  
Credential: MS PT MPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SALZER
OtherFirstName: JENNIFER
OtherMiddleName: M
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: PT
OtherLastNameType: 1
Mailing Information
Address1: 4560 SE INTERNATIONAL WAY SUITE 100
Address2: CONSONUS HEALTHCARE SERVICES
City: MILWAUKIE
State: OR
PostalCode: 97222
CountryCode: US
TelephoneNumber: 9712065149
FaxNumber: 9712065209
Practice Location
Address1: 4560 SE INTERNATIONAL WAY SUITE 100
Address2: CONSONUS HEALTHCARE SERVICES
City: MILWAUKIE
State: OR
PostalCode: 97222
CountryCode: US
TelephoneNumber: 9712065149
FaxNumber: 9712065209
Other Information
ProviderEnumerationDate: 12/11/2006
LastUpdateDate: 10/23/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X33237CAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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