Provider Demographics
NPI:1851808505
Name:LEMASTER, IRILLA MAE
Entity Type:Individual
Prefix:
First Name:IRILLA
Middle Name:MAE
Last Name:LEMASTER
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 2217
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:OR
Mailing Address - Zip Code:97438-0298
Mailing Address - Country:US
Mailing Address - Phone:541-221-4933
Mailing Address - Fax:
Practice Address - Street 1:85961 EDENVALE RD SPC 41
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:OR
Practice Address - Zip Code:97455-9741
Practice Address - Country:US
Practice Address - Phone:541-221-4933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant