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NPI 1831394980 · on the registry since 2007 · sole proprietor

Practice

Address
168 Lavender Ln
Central Point, OR 97502
Phone
(541) 664-4677

Registry record

Primary taxonomy
Lodging Provider
177F00000X
Licence states on file
OR
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon