Healthcare Provider Details

I. General information

NPI: 1417884388
Provider Name (Legal Business Name): CHARMAINE MONIQUE LACHAPELLE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 JEFFERY PL
PHILOMATH OR
97370-9215
US

IV. Provider business mailing address

365 JEFFERY PL
PHILOMATH OR
97370-9215
US

V. Phone/Fax

Practice location:
  • Phone: 541-829-9605
  • Fax:
Mailing address:
  • Phone: 541-829-9605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number201041874RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: