Healthcare Provider Details

I. General information

NPI: 1588599443
Provider Name (Legal Business Name): JENNA M OLIETTI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3495 CHAMBERS ST
EUGENE OR
97405-1967
US

IV. Provider business mailing address

3495 CHAMBERS ST
EUGENE OR
97405-1967
US

V. Phone/Fax

Practice location:
  • Phone: 541-513-2470
  • Fax:
Mailing address:
  • Phone: 541-513-2470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number10010789
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: