Provider Demographics
NPI:1568577104
Name:BARRETT, REBECCA MARY
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:MARY
Last Name:BARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 234
Mailing Address - Street 2:
Mailing Address - City:ECHO
Mailing Address - State:OR
Mailing Address - Zip Code:97826-0234
Mailing Address - Country:US
Mailing Address - Phone:541-376-5002
Mailing Address - Fax:
Practice Address - Street 1:3225 STATE ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-5063
Practice Address - Country:US
Practice Address - Phone:503-584-2301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR67460163WX0003X
OR163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
Not Answered163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn