Healthcare Provider Details

I. General information

NPI: 1477464105
Provider Name (Legal Business Name): IRYNA SHCHEGLYAK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1096 HOFFMAN RD NE
SALEM OR
97301-2101
US

IV. Provider business mailing address

1096 HOFFMAN RD NE
SALEM OR
97301-2101
US

V. Phone/Fax

Practice location:
  • Phone: 971-273-6459
  • Fax:
Mailing address:
  • Phone: 971-273-6459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number519222
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: