Healthcare Provider Details

I. General information

NPI: 1356163240
Provider Name (Legal Business Name): MONICA EUGENIA HUTANU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2024
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3377 RIVERBEND DR
SPRINGFIELD OR
97477-8803
US

IV. Provider business mailing address

1150 DARLENE LN APT 173
EUGENE OR
97401-1108
US

V. Phone/Fax

Practice location:
  • Phone: 541-222-6200
  • Fax: 541-222-6182
Mailing address:
  • Phone: 810-908-7651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA222416
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: