Provider Demographics
NPI:1164554028
Name:TREANOR, JUDITH M (RN)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:M
Last Name:TREANOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2865 NW ROYAL OAKS DR
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-3164
Mailing Address - Country:US
Mailing Address - Phone:541-758-3452
Mailing Address - Fax:541-926-8903
Practice Address - Street 1:315 SW 4TH AVE.
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2435
Practice Address - Country:US
Practice Address - Phone:541-967-3888
Practice Address - Fax:541-926-8903
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health