DR. LARA JAE GAMELIN M.D. NPI 1144390592

NPI Information

NPI: 1144390592
Provider Name: DR. LARA JAE GAMELIN, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Organization: CORVALLIS FAMILY MEDICINE PC

PECOS Registration: Yes

Address:
2400 NW KINGS BLVD
CORVALLIS, OR
ZIP 97330
Phone: (541) 757-2400
Get Directions

DR. Lara Jae Gamelin, M.D. is a family medicine in Corvallis, OR with 31 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Lara Jae Gamelin, M.D. NPI is 1144390592. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2400 NW KINGS BLVD
CORVALLIS, OR
ZIP 97330-900
Phone: (541) 757-2400
Fax: (541) 752-0931

The NPI 1144390592 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/9/2006 and was last updated on 12/8/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		MD19740	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	931288530	OTHER	OR	TAX OR BUSINESS ID NUMBER
2	G22564	MEDICARE UPIN	OREGON
3	108688	MEDICARE ID-TYPE UNSPECIFIED	OREGON
4	078225	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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