Provider Demographics
NPI:1003026105
Name:GRENZ, DEBRA LYNN (BS)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYNN
Last Name:GRENZ
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1057 LINCOLN ST SW
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1868
Mailing Address - Country:US
Mailing Address - Phone:541-917-0687
Mailing Address - Fax:
Practice Address - Street 1:729 7TH AVE SW
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2321
Practice Address - Country:US
Practice Address - Phone:541-230-4305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator