Individual
RUTHIE FAYE BERRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1640 G STREET, SPRINGFIELD, OR 97477
(541) 682-3569
(541) 682-9897
Mailing address
1132 CHELSEA AVE NW, SALEM, OR 97304-3122
(503) 581-4873
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
200542670RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200542670RN
OREGON STATE BOARD OF NURSING
OR
Enumeration date
06/15/2010
Last updated
06/15/2010
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