Provider Demographics
NPI:1609766054
Name:RASAVAGE, CINDY LEE
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:LEE
Last Name:RASAVAGE
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 1:26023 GIRL SCOUT RD
Mailing Address - Street 2:
Mailing Address - City:VENETA
Mailing Address - State:OR
Mailing Address - Zip Code:97487-9653
Mailing Address - Country:US
Mailing Address - Phone:541-913-4763
Mailing Address - Fax:
Practice Address - Street 1:123 INTERNATIONAL WAY
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-1047
Practice Address - Country:US
Practice Address - Phone:458-205-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR096000478RN163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No163WW0000XNursing Service ProvidersRegistered NurseWound Care