Healthcare Provider Details

I. General information

NPI: 1942196589
Provider Name (Legal Business Name): MEIRA POMEGRANATE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31537 GLENFIDDICH WAY
EUGENE OR
97405-9518
US

IV. Provider business mailing address

969 HIWAN CT
EUGENE OR
97405-4551
US

V. Phone/Fax

Practice location:
  • Phone: 541-232-3618
  • Fax:
Mailing address:
  • Phone: 541-232-3618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number201391508
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number201391508RN
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number201391508RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: