Provider Demographics
NPI:1467698894
Name:BAGGETT, GAIL CARPENTER (PT)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:CARPENTER
Last Name:BAGGETT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:GAIL
Other - Middle Name:CHRISTINE
Other - Last Name:CARPENTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 1360
Mailing Address - Street 2:
Mailing Address - City:PHILOMATH
Mailing Address - State:OR
Mailing Address - Zip Code:97370-1360
Mailing Address - Country:US
Mailing Address - Phone:541-737-9355
Mailing Address - Fax:541-737-4530
Practice Address - Street 1:425 SW 26TH ST
Practice Address - Street 2:OREGON STATE UNIVERSITY - DIXON RECREATION CENTER
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97331
Practice Address - Country:US
Practice Address - Phone:541-737-9355
Practice Address - Fax:541-737-7721
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004931225100000X
IA03890225100000X
OR5833225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist