Mary Benowitz Rebagliati, MD
Individual provider Active NPI Pediatrics Physician · Clackamas, OR
NPI 1740317445 · NPPES record last updated Apr 1, 2008
Key facts
- NPI
- 1740317445
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- MD15865 (OR)
- Practice address
- 10180 SE Sunnyside Rd
Clackamas, OR 97015-9764 - Phone
- (503) 652-2880
- NPI assigned
- Feb 28, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD15865 | OR | MD | Pediatrics Physician |
Interoperability endpoints
- mrebagliati66513@ghc.direct-ci.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD15865 | OR | Yes |
Addresses
Primary practice location
10180 SE Sunnyside Rd
Clackamas, OR 97015-9764
Mailing address
10180 SE Sunnyside Road
Clackamas, OR 97015-9764
Phone (503) 652-2880
Other names
- Mary Benowitz Rebagliati
Other providers in Clackamas, OR
- Benchmark Physical Therapy of Or, LLC
- Samantha Benesh
- David Benjamin
- Haley Julia Bennett
- Riney Clare Bennett
- Zakary Syl Benson
- Cody Jens Benthin
- Kacey Allison Berberich
- Laurel R Berge
- Alexander Patrick Berger
All providers in Clackamas, OR · Pediatrics Physician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.