1659103216 NPI number — DANIELLE ELAINA BAUMGARTNER MSW

Table of content: DANIELLE ELAINA BAUMGARTNER MSW (NPI 1659103216)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659103216 NPI number — DANIELLE ELAINA BAUMGARTNER MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAUMGARTNER
Provider First Name:
DANIELLE
Provider Middle Name:
ELAINA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

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

NPI Number Information

NPI Number:
1659103216
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8907 YANK GULCH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TALENT
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97540-7772
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-279-0194
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
DEPARTMENT OF VETERANS AFFAIRS
Provider Second Line Business Practice Location Address:
8495 CRATER LAKE HWY
Provider Business Practice Location Address City Name:
WHITE CITY
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-826-2111
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/14/2024

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: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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