Healthcare Provider Details

I. General information

NPI: 1326984568
Provider Name (Legal Business Name): ROSHNY BHAKTA MARTUSCELLI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2018 GARDEN AVE
EUGENE OR
97403-1969
US

IV. Provider business mailing address

2074 MUSKET ST
EUGENE OR
97408-4624
US

V. Phone/Fax

Practice location:
  • Phone: 541-510-4631
  • Fax:
Mailing address:
  • Phone: 541-912-3723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number110770
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: