| NPI | 1013458405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIELLE FEY Owner 541-507-4141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 201604728NP) |
| Enumeration Date | 2017-03-17 |
| Last Update Date | 2017-03-17 |