Provider Demographics
NPI:1265222608
Name:GEARY, LORA
Entity type:Individual
Prefix:
First Name:LORA
Middle Name:
Last Name:GEARY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 SW JEFFERSON WAY
Mailing Address - Street 2:203 PHARMACY BUILDING
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97331-8656
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1601 SW JEFFERSON WAY
Practice Address - Street 2:203 PHARMACY BUILDING
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97331-8656
Practice Address - Country:US
Practice Address - Phone:541-737-3424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPI-0014260390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program