Healthcare Provider Details

I. General information

NPI: 1730700683
Provider Name (Legal Business Name): RANILLA F MORI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2020
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1022 GREEN ACRES RD
EUGENE OR
97408-6501
US

IV. Provider business mailing address

445 HUNSAKER LN
EUGENE OR
97404-2417
US

V. Phone/Fax

Practice location:
  • Phone: 541-682-3550
  • Fax:
Mailing address:
  • Phone: 360-771-9816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberPA207233
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: