Basic Information
| Provider Information | |||||||||
| NPI: | 1053342279 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARRINGTON-SHULENBERGER | ||||||||
| FirstName: | ROSA | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DNP, ANP, FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20170 N UMPQUA HWY | ||||||||
| Address2: | |||||||||
| City: | GLIDE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974439620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5418701363 | ||||||||
| FaxNumber: | 5414963489 | ||||||||
| Practice Location | |||||||||
| Address1: | UMPQUA COMMUNITY HEALTH CENTER, GLIDE CLINIC | ||||||||
| Address2: | 20170 N UMPQUA HWY | ||||||||
| City: | GLIDE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5414963504 | ||||||||
| FaxNumber: | 5414963489 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2006 | ||||||||
| LastUpdateDate: | 05/03/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 089003375N3 | OR | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LF0000X | 200450006NP | OR | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 052220 | 05 | OR | MEDICAID |