Healthcare Provider Details

I. General information

NPI: 1841440831
Provider Name (Legal Business Name): CARLA MARKS R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2008
Last Update Date: 09/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 SUZANNE WAY STE 200
EUGENE OR
97408-7619
US

IV. Provider business mailing address

2650 SUZANNE WAY STE 200
EUGENE OR
97408-7619
US

V. Phone/Fax

Practice location:
  • Phone: 541-228-3096
  • Fax: 541-228-3185
Mailing address:
  • Phone: 541-228-3096
  • Fax: 541-228-3185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License Number09400641ORN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: