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:
Health care specialties
| Specialty | Code | License # | 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 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285622589 | NPPES |
| Oregon | MEDICAID | 134132 |
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