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NPI Code Detail

MEDICARE: SAMANTHA ANN WRIGHT

MEDICARE: SAMANTHA ANN WRIGHT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1629549365
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA ANN WRIGHT
Provider Business Mailing Address
First Line : 627 NE EVANS ST
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-3923
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 213 NE 10TH ST
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-4825
Country : US
Telephone Number : 503-895-0934
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2018
Last Update Date : 12/06/2018

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Directions to “ SAMANTHA ANN WRIGHT ” Practice Location

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