Individual
REBECCA RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5781 MAIN ST, SPRINGFIELD, OR 97478-5426
(541) 640-7625
(541) 644-3477
Mailing address
PO BOX 4858, PORTLAND, OR 97208-4858
(541) 640-7625
(541) 644-3477
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
202113960NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500802696
—
OR
Enumeration date
12/10/2021
Last updated
01/19/2023
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