IndividualActive
Jennifer O'Sullivan, ATC
NPI 1699394585 · Athletic Trainer · Independence, OR
Provider details
- NPI number
- 1699394585
- Entity type
- Individual
- Primary specialty
- Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- ATC
- Sex
- Female
- Sole proprietor
- No
- License
- AT-AT-1000383 (OR)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
1369 Monmouth St
Independence, OR 97351-1126
Phone: (503) 507-0977
Approximate (ZIP-level) locationGet directions
Mailing address
16400 Ellendale Rd
Dallas, OR 97338-9665
Registry dates
- Enumerated
- 2020-04-10
- Last updated
- 2020-04-10
- Certified
- 2020-04-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.