Provider Demographics
NPI:1144428079
Name:MONREAL, REBECA M (DO)
Entity Type:Individual
Prefix:DR
First Name:REBECA
Middle Name:M
Last Name:MONREAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 22ND STREET SOUTH EAST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-6558
Mailing Address - Country:US
Mailing Address - Phone:503-967-6771
Mailing Address - Fax:503-385-8421
Practice Address - Street 1:1100 22ND ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-6558
Practice Address - Country:US
Practice Address - Phone:503-967-6771
Practice Address - Fax:503-385-8421
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO1548602081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500641042Medicaid