GLENN ALBERT FAIRALL (NPI# 1982169611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982169611 |
| Entity Type | Individual |
| Full Name | GLENN ALBERT FAIRALL |
| Practice Address |
2532 Nw Ashley Dr Albany OR 97321-1395 |
| Mailing Address |
Po Box 741 Albany OR 97321-0252 |
| Practice Telephone | 5419791019 |
| Mailing Telephone | 5419791019 |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2019-02-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156F00000X | Technician/Technologist | 88193 | OR | Eye and Vision Services Providers |
| Street Address |
2532 NW ASHLEY DR |
| City | ALBANY |
| State | OR |
| Zip Code | 97321-1395 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730659228 | Waverly Assisted Living, LLC | In Home Supportive Care | 2853 Salem Ave Se Ste A, Albany, OR 97321 | 2018-11-28 |
| 1558838706 | Greater Albany Public Schools 8j | Local Education Agency (LEA) | 718 Seventh Ave. Sw, Albany, OR 97321 | 2018-10-25 |
| 1396232237 | Chiho Sakamoto Gunton | Social Worker | 227 Sw 3rd Avenue, Albany, OR 97321 | 2018-04-17 |
| 1700333184 | Albany General Hospital | Clinic/Center | 534 Pleasant View Way Nw, Suite 400, Albany, OR 97321 | 2016-09-02 |
| 1811373772 | Katrin M Ridge | Pharmacist | 1010 7th Ave. Sw., Albany, OR 97321 | 2015-08-03 |
| 1720485527 | Heartsong Counseling | Counselor | 425 Sw 2nd Ave. #203, Albany, OR 97321 | 2014-11-24 |
| 1619386604 | Courtney Ann Miller | Dentist | 2815 Willetta St, Suite A-1, Albany, OR 97321 | 2014-08-05 |
| 1346664810 | Jeffrey Othniel Nordtvedt | Case Manager/Care Coordinator | 2730 Sw Pacific Boulevard, Albany, OR 97321 | 2014-02-05 |
| 1174872022 | Albany General Hospital | Internal Medicine | 631 Southwest Elm Street, Suite 200, Albany, OR 97321 | 2012-09-06 |
| 1144594532 | Russell Travis | Pharmacist | 1177 Waverly Dr, Albany, OR 97321 | 2012-03-02 |
| Find all providers in zip 97321 | ||||
| Taxonomy Code | 156F00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| A broad category grouping different kinds of technologists and technicians. See individual definitions. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093204257 | Mistir Mulatu | Technician/Technologist | 15065 Sw Opal Dr, Beaverton, OR 97007-8770 | 2018-05-03 |
| 1598030256 | Christopher Paul Jacques | Technician/Technologist | 872 W Main St Apt C27, Molalla, OR 97038-8865 | 2012-03-14 |
| 1538786280 | Maria C Calderon Siquina | Technician/Technologist | 619 Nw 6th Ave Fl 1, Portland, OR 97209-3964 | 2020-06-29 |
| 1255950275 | Amiee Michele Grimes I | Technician/Technologist | 3647 Highway 39, Klamath Falls, OR 97603-2612 | 2020-04-09 |
| 1386272490 | Tiffany Hart | Technician/Technologist | 806 Nw 6th St, Grants Pass, OR 97526-1525 | 2020-04-01 |
| 1124654215 | Cheyenne Renee Massey | Technician/Technologist | 3647 Highway 39, Klamath Falls, OR 97603-2612 | 2020-03-20 |
| 1356975155 | Shelia L Baker | Technician/Technologist | 2200 4th St, Baker City, OR 97814-2615 | 2020-03-02 |
| 1407480205 | Stephenie A Allen | Technician/Technologist | 2200 4th St, Baker City, OR 97814-2615 | 2020-03-02 |
| 1689208472 | Paul L Munson | Technician/Technologist | 2100 Main St, Baker City, OR 97814-2655 | 2020-03-02 |
| 1699306183 | Andrea Allen | Technician/Technologist | 3512 Lone Pine Rd, Medford, OR 97504-5637 | 2020-02-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.