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1114740180
NICOLE TIEFENBACK
GRANTS PASS, OR
NPI
1114740180
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2024-11-06
Last Update Date
2024-11-06
Business Address
NICOLE TIEFENBACK
356 NE BEACON DR
GRANTS PASS, OR 97526-3815
Phone number: 541-529-5156
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Mailing Address
NICOLE TIEFENBACK
PO BOX 1121
ROSEBURG, OR 97470-0254
Phone number: 541-672-2691
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