# NIPTAR, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154780427
- **Authorized official:** MR. ROBERT LEWIS GULLEY RRT (REGISTERED RESPIRATORY THERAPIST)
- **Authorized official phone:** (541) 401-9166

## Contact information

- **Practice address:** 1405 FILBERT ST, LEBANON, OR 97355-4018
- **Practice address phone:** (541) 401-3917
- **Mailing address:** 1405 FILBERT ST, LEBANON, OR 97355-4018
- **Mailing address phone:** (541) 401-3917

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 227900000X | Registered Respiratory Therapist | RT-P-000774 | OR | Yes |

## Other

- **Enumeration date:** 02/16/2016
- **Last updated:** 04/06/2016