Healthcare Provider Details

I. General information

NPI: 1467379057
Provider Name (Legal Business Name): MARIN E KEEFE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 NW SAMARITAN DR
CORVALLIS OR
97330-3737
US

IV. Provider business mailing address

2470 NW ROLLING GREEN DR APT 41
CORVALLIS OR
97330-3951
US

V. Phone/Fax

Practice location:
  • Phone: 541-768-5111
  • Fax:
Mailing address:
  • Phone: 503-896-1406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number10056206
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: