Search › Oregon › 1041C0700X
Jack Otterstrom, LCSW
NPI 1922163096 · on the registry since 2006 · sole proprietor
Practice
- Address
- 656 Jasmine Cir
Independence, OR 97351 - Phone
- (541) 231-8023
Additional practice sites
- 250 W Marquam St, Mount Angel, OR
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 101YP2500X
1041C0700X - Licence states on file
- OR
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-09-06
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon