Healthcare Provider Details

I. General information

NPI: 1891821005
Provider Name (Legal Business Name): SHIRLIN GAUTHIER ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHIRLIN GAUTHIER D.C., ANP

II. Dates (important events)

Enumeration Date: 02/24/2007
Last Update Date: 06/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 RIVER RD STE 101
EUGENE OR
97404
US

IV. Provider business mailing address

5370 DONOHOE AVE
EUGENE OR
97402-7401
US

V. Phone/Fax

Practice location:
  • Phone: 541-431-0631
  • Fax: 541-687-8631
Mailing address:
  • Phone: 541-207-4835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberCH0006445
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP 618832
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number200550016
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: