Provider Demographics
NPI:1629365325
Name:GARRETT, BETSY JAYNE
Entity Type:Individual
Prefix:MS
First Name:BETSY
Middle Name:JAYNE
Last Name:GARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BETSY
Other - Middle Name:JAYNE
Other - Last Name:GARRETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:2255 14TH AVE SE
Mailing Address - Street 2:T-0609
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-8513
Mailing Address - Country:US
Mailing Address - Phone:541-791-9566
Mailing Address - Fax:541-791-9566
Practice Address - Street 1:2255 14TH AVE SE
Practice Address - Street 2:T-0609
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-8513
Practice Address - Country:US
Practice Address - Phone:541-791-9566
Practice Address - Fax:541-791-9566
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0007385183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist