Provider Demographics
NPI:1538696174
Name:BEAM, JENNIFER KAY (RRT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KAY
Last Name:BEAM
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:KAY
Other - Last Name:GOLSAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RRT
Mailing Address - Street 1:3000 MARKET ST NE STE 316
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-1810
Mailing Address - Country:US
Mailing Address - Phone:971-717-5171
Mailing Address - Fax:
Practice Address - Street 1:3000 MARKET ST NE STE 541
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-1835
Practice Address - Country:US
Practice Address - Phone:971-301-8309
Practice Address - Fax:971-301-8310
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-14
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRTP101358282279G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care