Provider Demographics
NPI:1053600395
Name:MONETTE-SHOWKER, MARLENE JOY (MSW)
Entity type:Individual
Prefix:MS
First Name:MARLENE
Middle Name:JOY
Last Name:MONETTE-SHOWKER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:MARLENE
Other - Middle Name:
Other - Last Name:MONETTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:2186 CITY VIEW ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-1529
Mailing Address - Country:US
Mailing Address - Phone:541-912-5957
Mailing Address - Fax:
Practice Address - Street 1:687 CHESHIRE AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-5060
Practice Address - Country:US
Practice Address - Phone:541-343-2993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR104100000X
ORL62411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker