Provider Demographics
NPI:1932908464
Name:PANGARUNGAN, DANA MAE CASAS
Entity type:Individual
Prefix:
First Name:DANA MAE
Middle Name:CASAS
Last Name:PANGARUNGAN
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 1:2966 HAWAIIAN AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-5040
Mailing Address - Country:US
Mailing Address - Phone:541-245-7472
Mailing Address - Fax:541-245-7472
Practice Address - Street 1:2966 HAWAIIAN AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-5040
Practice Address - Country:US
Practice Address - Phone:541-245-7472
Practice Address - Fax:541-245-7472
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-08
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201508271RN163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Single Specialty