Healthcare Provider Details

I. General information

NPI: 1205750569
Provider Name (Legal Business Name): PAULA DEMARIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 7TH AVE SW
ALBANY OR
97321-2320
US

IV. Provider business mailing address

718 7TH AVE SW
ALBANY OR
97321-2320
US

V. Phone/Fax

Practice location:
  • Phone: 541-967-4505
  • Fax: 541-967-4587
Mailing address:
  • Phone: 541-967-4505
  • Fax: 541-967-4587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: