Active NPI
Marissa Alexandra Gallegos, THW DOULA
- Doula
- Corvallis, OR
National Provider Identifier
1043901143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Doula
- License
- THW000108581
- Practice address
- 520 NW 4TH St
Corvallis, OR 97330-6411 - Phone
- (541) 908-6919
- NPI assigned
- May 18, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Doula | 374J00000X | THW000108581 | OR | Primary |
Addresses
Primary practice location
520 NW 4TH St
Corvallis, OR 97330-6411
Mailing address
PO Box 75
Corvallis, OR 97339-0075
Phone (541) 908-6919
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| THW000108581 | OR | MD | Doula |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684368000000",
"number": "1043901143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 75",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973390075",
"telephone_number": "541-908-6919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 NW 4TH ST",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973306411",
"telephone_number": "541-908-6919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLEGOS",
"first_name": "MARISSA",
"middle_name": "ALEXANDRA",
"credential": "THW DOULA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-18",
"last_updated": "2023-05-18",
"certification_date": "2023-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": "OR",
"license": "THW000108581",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.