| Doctor Name: | MR. JESSE KENNETH ORTEL |
| NPI Number: | 1093705709 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MPT, OCS, CERT MDT |
| License Number: | 2305005797 |
| Business Practice Address: | 1 Jarrett White Rd Tripler Army Medical Center Tripler Amc, HI - 968595001 |
| Business Phone Number: | 8084332460 |
| Business Fax Number: | 8084331558 |
| Mailing Address: | 1 Jarrett White Rd, Tripler Army Medical Center Attn: Mchk-qs TRIPLER AMC |
| State: | HI |
| Postal Code: | 968595001 |
| Phone Number: | 8084332460 |
| Fax Number: | 8084331558 |
| NPI Enumeration Date: | 10/24/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 2305005797 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |