Healthcare Provider Details

I. General information

NPI: 1689492258
Provider Name (Legal Business Name): STARI SKYE BARKLOW BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STARI SKYE MORALEZ

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 ORIOLE ST
SPRINGFIELD OR
97477-7533
US

IV. Provider business mailing address

3130 ORIOLE ST
SPRINGFIELD OR
97477-7533
US

V. Phone/Fax

Practice location:
  • Phone: 541-636-6551
  • Fax:
Mailing address:
  • Phone: 541-636-6551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number10011603
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: