Provider Demographics
NPI:1144869462
Name:RAMIREZ, DENISE A
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:A
Last Name:RAMIREZ
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 1:137 NE 1ST ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-3042
Mailing Address - Country:US
Mailing Address - Phone:541-272-3740
Mailing Address - Fax:
Practice Address - Street 1:137 NE 1ST ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-3042
Practice Address - Country:US
Practice Address - Phone:541-272-3740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORIHNMedicaid