Provider Demographics
NPI:1215176326
Name:BATIE, JEFFRY (LAC)
Entity type:Individual
Prefix:
First Name:JEFFRY
Middle Name:
Last Name:BATIE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16227 SW HOLLAND LN
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-9437
Mailing Address - Country:US
Mailing Address - Phone:503-867-1994
Mailing Address - Fax:
Practice Address - Street 1:16227 SW HOLLAND LN
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-9437
Practice Address - Country:US
Practice Address - Phone:503-867-1994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC01205171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist