Provider Demographics
NPI:1942292305
Name:COVEY, MARLENE ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARLENE
Middle Name:ANNE
Last Name:COVEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 SW OTTER WAY
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-1894
Mailing Address - Country:US
Mailing Address - Phone:541-728-8530
Mailing Address - Fax:
Practice Address - Street 1:735 SW OTTER WAY
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1894
Practice Address - Country:US
Practice Address - Phone:541-728-8530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-21
Last Update Date:2015-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD26887207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8924745Medicaid
OR213840Medicaid
VA006213871Medicaid
ORE04317Medicare UPIN
OR213840Medicaid