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General NPI Number Information
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NPI Number | 1093625089
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Entity Type | Individual
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Provider Name | AMELIA BEVILLE
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Gender | Female
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Dates
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Enumeration Date | 09/10/2026
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Last Update Date | 09/10/2026
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Provider Practice Location Address
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Address Line | 3000 MARKET ST NE STE 327
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City | SALEM
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State | OR
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Zip | 97301-1834
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Country | US
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Telephone | 971-707-0387
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Fax |
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Provider Business Mailing Address
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Address Line | 522 FLAMINGO AVE
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City | SPRINGFIELD
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State | OR
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Zip | 97477-7511
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Country | US
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Telephone | 818-389-8248
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | BAP-E-10264953
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License Number State | OR
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