Healthcare Provider Details

I. General information

NPI: 1467810473
Provider Name (Legal Business Name): DEBRA CHRISTINE SAMANO-HOPPER R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2016
Last Update Date: 04/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 HILYARD ST SUITE 570
EUGENE OR
97401-8122
US

IV. Provider business mailing address

2910 JEFFERSON ST
EUGENE OR
97405-2510
US

V. Phone/Fax

Practice location:
  • Phone: 458-205-7070
  • Fax:
Mailing address:
  • Phone: 541-484-2909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number200241756RN
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number200241756RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: