MEDICARE: ORIA GYNNETTE OBERHOLTZER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula

General Provider Information

NPI Number	:	1144099771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ORIA GYNNETTE OBERHOLTZER

Provider Business Mailing Address
First Line	:	2160 CLEVELAND ST
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97405-1537
Country	:	US
Telephone Number	:	541-514-3323
Fax Number	:

Provider Business Practice Location Address
First Line	:	2160 CLEVELAND ST
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97405-1537
Country	:	US
Telephone Number	:	541-514-3323
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2023
Last Update Date	:	12/19/2024

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