1508853847 NPI number — JOANN NMI DONALDSON CRNA

Table of content: DR. ERIC C. PARLETTE M.D. (NPI 1386624567)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508853847 NPI number — JOANN NMI DONALDSON CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DONALDSON
Provider First Name:
JOANN
Provider Middle Name:
NMI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GODBY
Provider Other First Name:
JOANN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1508853847
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1550 OAK ST
Provider Second Line Business Mailing Address:
OREGON EYE SURGERY CENTER
Provider Business Mailing Address City Name:
EUGENE
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97401-7701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-484-4988
Provider Business Mailing Address Fax Number:
541-434-0960

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1550 OAK ST
Provider Second Line Business Practice Location Address:
OREGON EYE SURGERY CENTER
Provider Business Practice Location Address City Name:
EUGENE
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97401-7701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-484-4988
Provider Business Practice Location Address Fax Number:
541-434-0960
Provider Enumeration Date:
10/03/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 297925 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".




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