Provider Demographics
NPI:1942196589
Name:POMEGRANATE, MEIRA
Entity type:Individual
Prefix:
First Name:MEIRA
Middle Name:
Last Name:POMEGRANATE
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 HIWAN CT
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-4551
Mailing Address - Country:US
Mailing Address - Phone:541-232-3618
Mailing Address - Fax:
Practice Address - Street 1:31537 GLENFIDDICH WAY
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-9518
Practice Address - Country:US
Practice Address - Phone:541-232-3618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201391508163W00000X
OR201391508RN163WG0000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice