Provider Demographics
NPI:1215176284
Name:MEADOWS, MARLENE
Entity type:Individual
Prefix:
First Name:MARLENE
Middle Name:
Last Name:MEADOWS
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:PO BOX 742
Mailing Address - Street 2:
Mailing Address - City:ATHENA
Mailing Address - State:OR
Mailing Address - Zip Code:97813-0742
Mailing Address - Country:US
Mailing Address - Phone:541-566-2169
Mailing Address - Fax:
Practice Address - Street 1:223 EAST GARFILED ST.
Practice Address - Street 2:
Practice Address - City:ATHENA
Practice Address - State:OR
Practice Address - Zip Code:97813
Practice Address - Country:US
Practice Address - Phone:541-566-2169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-13
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200940077RN163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health