Pairish-Lack, Jeri

Pairish-Lack, Jeri is an individual health care provider with primary practice located at 124 Nw Midland Ave Ste J, Grants Pass OR 97526-1269. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Allopathic & Osteopathic Physicians / Family Medicine. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Pairish-Lack, Jeri can be contacted via phone (541) 476-8859.

Contact Information

Primary practice address
124 Nw Midland Ave Ste J Grants Pass OR 97526-1269
Phone: (541) 476-8859
Fax: (541) 955-8611
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 094006084N1 Oregon
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X Oregon

Profile Details

NPI number 1497754329
LBN Legal business name Pairish-Lack, Jeri
Credentials Certified Family Nurse Practitioner (CFNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2005
Last updated Oct 1st, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497754329 NPPES
Oregon MEDICAID 000473

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