Provider Demographics
NPI:1710131255
Name:MEADORS, PATRICIA ANNE I
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANNE
Last Name:MEADORS
Suffix:I
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 1:31945 ROLLAND DR UNIT 10
Mailing Address - Street 2:
Mailing Address - City:TANGENT
Mailing Address - State:OR
Mailing Address - Zip Code:97389-9716
Mailing Address - Country:US
Mailing Address - Phone:541-220-9296
Mailing Address - Fax:
Practice Address - Street 1:229 4TH AVE SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2815
Practice Address - Country:US
Practice Address - Phone:541-928-4084
Practice Address - Fax:541-928-9259
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker