1639430887 NPI number — MRS. CARRIE F. MEADOWCROFT OT, CHT

Table of content: MRS. CARRIE F. MEADOWCROFT OT, CHT (NPI 1639430887)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639430887 NPI number — MRS. CARRIE F. MEADOWCROFT OT, CHT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEADOWCROFT
Provider First Name:
CARRIE
Provider Middle Name:
F.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
OT, CHT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BLAIR
Provider Other First Name:
CARRIE
Provider Other Middle Name:
F.
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
OT, CHT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1639430887
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/05/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1292 HIGH STREET
Provider Second Line Business Mailing Address:
SUITE 224
Provider Business Mailing Address City Name:
EUGENE
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97401-3238
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-345-8760
Provider Business Mailing Address Fax Number:
541-345-8763

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
598 E. 13TH AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EUGENE
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-636-3473
Provider Business Practice Location Address Fax Number:
541-636-3480
Provider Enumeration Date:
06/05/2012

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: 225XH1200X , with the licence number:  983968 , 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)





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