Provider Demographics
NPI:1881145191
Name:GARRATT, STEPHEN GREGORY (FNP)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:GREGORY
Last Name:GARRATT
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:GARRATT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:3500 CHAD DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408
Mailing Address - Country:US
Mailing Address - Phone:541-683-5001
Mailing Address - Fax:541-683-1422
Practice Address - Street 1:520 COUNTY CLUB ROAD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-683-5001
Practice Address - Fax:541-683-1422
Is Sole Proprietor?:No
Enumeration Date:2016-10-21
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202104391NP-PP363LF0000X
CA95005205363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500793052Medicaid