Provider Demographics
NPI:1972021707
Name:DIMITRE, VIRGINIA (NP)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:DIMITRE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87787 CEDAR FLAT RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97478-9632
Mailing Address - Country:US
Mailing Address - Phone:541-729-4988
Mailing Address - Fax:
Practice Address - Street 1:BETTS PSYCHIATRIC
Practice Address - Street 2:911 COUNTRY CLUB RD., SUITE 340
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6044
Practice Address - Country:US
Practice Address - Phone:541-505-8621
Practice Address - Fax:541-654-5063
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201707001NP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health