Bennett, Stephen A

Bennett, Stephen A is an individual health care provider with primary practice located at 1128 Ne 2Nd St Suite 201, Corvallis OR 97330-6230. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Bennett, Stephen A can be contacted via phone (541) 257-2512.

Contact Information

Primary practice address
1128 Ne 2Nd St Suite 201 Corvallis OR 97330-6230
Phone: (541) 257-2512
Fax: (541) 754-2707
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA00868 Oregon

Profile Details

NPI number 1285622589
LBN Legal business name Bennett, Stephen A
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2005
Last updated Jun 18th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285622589 NPPES
Oregon MEDICAID 134132

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