Provider Demographics
NPI:1336307867
Name:BARCENAS, LORA RAYLENE
Entity Type:Individual
Prefix:
First Name:LORA
Middle Name:RAYLENE
Last Name:BARCENAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LORA
Other - Middle Name:RAYLENE
Other - Last Name:NESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:691 SITKA DEER CT NW
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-3685
Mailing Address - Country:US
Mailing Address - Phone:503-851-9690
Mailing Address - Fax:
Practice Address - Street 1:3180 CENTER ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4532
Practice Address - Country:US
Practice Address - Phone:503-588-5357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-31
Last Update Date:2008-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator