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Nursing Service Related Providers Technician Attendant Care Provider

Provider NPI: 1053763508

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
530 NW 27TH ST  CORVALLIS, OR 97330-5223 US
Tel: 541-766-6835  Fax: 541-766-6186

Business Mailing Address:
530 NW 27TH ST  CORVALLIS, OR 97330-5223 US
Tel: 541-766-6835  Fax: 541-766-6186

NPI Information:
NPI: 1053763508
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y3747A0650XNursing Service Related Providers
Attendant Care Provider

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 3747A0650X





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