Provider Demographics
NPI:1093970485
Name:RAPOZA, EVANGELINA Y
Entity Type:Individual
Prefix:
First Name:EVANGELINA
Middle Name:Y
Last Name:RAPOZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MONA
Other - Middle Name:Y
Other - Last Name:RAPOZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 579
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97339-0579
Mailing Address - Country:US
Mailing Address - Phone:541-766-6835
Mailing Address - Fax:541-766-6186
Practice Address - Street 1:530 NW 27TH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-5223
Practice Address - Country:US
Practice Address - Phone:541-766-6835
Practice Address - Fax:541-766-6186
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider