JERRY KORKOW PSS NPI 1306555958

NPI Information

NPI: 1306555958
Provider Name: JERRY KORKOW, PSS
Classification: Peer Specialist - 175T00000X
Entity Type: Individual
Address:
280 NE SANTIAM BLVD
MILL CITY, OR
ZIP 97360
Phone: (971) 332-5676
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Jerry Korkow, PSS is a peer specialist in Mill City, OR. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. Jerry Korkow, PSS NPI is 1306555958. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

280 NE SANTIAM BLVD
MILL CITY, OR
ZIP 97360
Phone: (971) 332-5676

The enumeration date for this NPI number is 11/22/2022 and was last updated on 11/22/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	175T00000X	Peer Specialist		THW000107518	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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