Healthcare Provider Details

I. General information

NPI: 1306034525
Provider Name (Legal Business Name): REBECCA GARRETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2007
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OSU-SHS 108 SW MEMORIAL PLACE 201 PLAGEMAN BUILDING
CORVALLIS OR
97331-5801
US

IV. Provider business mailing address

OSU- STUDENT HEALTH 108 SW MEMORIAL PLACE 201 PLAGEMAN
CORVALLIS OR
97331-5801
US

V. Phone/Fax

Practice location:
  • Phone: 541-737-9355
  • Fax: 541-737-9694
Mailing address:
  • Phone: 541-737-9355
  • Fax: 541-737-9694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: