Healthcare Provider Details

I. General information

NPI: 1629067756
Provider Name (Legal Business Name): BECKY JANE HOWARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BECKY JANE LEE

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
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: 541-686-9000
  • Fax: 541-242-4585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number201392023NP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: