Provider Demographics
NPI:1205189156
Name:OREGON REHABILITATION ASSOCIATION
Entity Type:Organization
Organization Name:OREGON REHABILITATION ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-585-3337
Mailing Address - Street 1:2405 FRONT ST NE
Mailing Address - Street 2:STE 150
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-0724
Mailing Address - Country:US
Mailing Address - Phone:503-585-3337
Mailing Address - Fax:503-585-3722
Practice Address - Street 1:2405 FRONT ST NE
Practice Address - Street 2:STE 150
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-0724
Practice Address - Country:US
Practice Address - Phone:503-585-3337
Practice Address - Fax:503-585-3722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health