Healthcare Provider Details

I. General information

NPI: 1962332684
Provider Name (Legal Business Name): SYDNIE MCCARTY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

438 NW 4TH ST APT 2
CORVALLIS OR
97330-6409
US

IV. Provider business mailing address

2460 NW JACKSON AVE APT 2
CORVALLIS OR
97330-5311
US

V. Phone/Fax

Practice location:
  • Phone: 541-452-1221
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: