Provider Demographics
NPI:1124224209
Name:PHILLIPS, DEBORAH A (PHD, ARNP)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:A
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:PHD, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3355 N DELTA HWY
Mailing Address - Street 2:#104
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-7194
Mailing Address - Country:US
Mailing Address - Phone:206-349-8362
Mailing Address - Fax:
Practice Address - Street 1:66 CLUB RD STE 160
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2439
Practice Address - Country:US
Practice Address - Phone:541-345-1722
Practice Address - Fax:541-485-7049
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201070014364SP0808X
OR201504380NP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health