NPI 1083744593

Mindy S Depue, ATC

Practitioner Athletic Trainer Corvallis, OR

Practice location

Address: 4444 NW Highland Dr, Corvallis, OR 97330-9734
Phone: (541) 766-4909
Mailing address: 2491 Waterford St SE, Albany, OR 97322-8818

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence AT-AT-1007419 (OR)

Other Specialist/Technologist providers in Oregon →

Registry record

NPI: 1083744593
Entity type: Individual
Sex (as registered): Female
NPI issued: 6 Mar 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.