Healthcare Provider Details

I. General information

NPI: 1700856606
Provider Name (Legal Business Name): ROLANDA R EVERETT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 09/20/2025
Certification Date: 09/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 N 19TH ST
SPRINGFIELD OR
97477-2526
US

IV. Provider business mailing address

PO BOX 1648
EUGENE OR
97440-1648
US

V. Phone/Fax

Practice location:
  • Phone: 541-746-5437
  • Fax:
Mailing address:
  • Phone: 541-242-4026
  • Fax: 541-242-4363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD21149
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: