| Jacquelynne Rose Carlson, | |
|
1812 N Lakewood Dr Ste 100, Coeur D Alene, ID 83814-2635 | |
| (208) 966-4476 | |
| (208) 966-4475 |
| Full Name | Jacquelynne Rose Carlson |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 1812 N Lakewood Dr Ste 100, Coeur D Alene, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982338885 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 121595 (Texas) | Primary |
| Provider Name | Scott & White Clinic |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1093779704 PECOS PAC ID: 8123923604 Enrollment ID: O20031223000640 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacquelynne Rose Carlson, 850 W Ironwood Dr Ste 202, Coeur D Alene, ID 83814-4903 Ph: (208) 664-2175 | Jacquelynne Rose Carlson, 1812 N Lakewood Dr Ste 100, Coeur D Alene, ID 83814-2635 Ph: (208) 966-4476 |
Lanmana Parys-wolodkewitsch, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 411 W Haycraft Ave Ste D4, Coeur D Alene, ID 83815 Phone: 208-664-2468 | |
Mr. Christy Sater Adams, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2200 Ironwood Pl, Coeur D Alene, ID 83814 Phone: 208-667-6486 | |
Sarah B Vore, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 411 W Haycraft Ave Ste D1, Coeur D Alene, ID 83815 Phone: 208-664-2468 | |
Taylor Lee Kroll, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 1812 N Lakewood Dr Ste 100, Coeur D Alene, ID 83814 Phone: 208-966-4476 Fax: 208-966-4475 | |
Autumn B Deda, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 500 W Aqua Ave, Coeur D Alene, ID 83815 Phone: 208-762-1122 | |
Megan Marney, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 411 W Haycraft Ave Ste D4, Coeur D Alene, ID 83815 Phone: 208-664-2468 | |
Clarence Andrew Sims, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1917 N Lakewood Dr, Coeur D Alene, ID 83814 Phone: 208-664-8194 Fax: 208-667-1847 |