Pengilly, Rebecca L

Pengilly, Rebecca L is an individual health care provider with primary practice located at 1705 Waverly Dr Se , Albany OR 97322-6952. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Pengilly, Rebecca L can be contacted via phone (541) 967-8221.

Contact Information

Primary practice address
1705 Waverly Dr Se Albany OR 97322-6952
Phone: (541) 967-8221
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5123 South Dakota
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD182380 Oregon

Profile Details

NPI number 1184603680
LBN Legal business name Pengilly, Rebecca L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 12th, 2006
Last updated Jun 29th, 2021 - about 3 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 1184603680 NPPES
South Dakota MEDICAID 5611360

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