CARISSA FAWN BLANK

EUGENE, OR
NPI1114356714
Former NameCARISSA FAWN WEBB
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: OR  201393726LPN)
Enumeration Date2013-11-04
Last Update Date2015-04-30
Business Address
-- CARISSA FAWN BLANK LPN
151 W 7TH AVE SUITE 100
EUGENE, OR 97401-1100
Phone number: 541-682-8779
Mailing Address
-- CARISSA FAWN BLANK LPN
25110 PERKINS RD
VENETA, OR 97487-9756
Phone number: 541-505-0498
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