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1265468912
PHYLLIS A PENGELLY
BEND, OR
NPI
1265468912
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LW0102X Nurse Practitioner, Women's Health
(Licence: OR 200350128np)
Enumeration Date
2006-06-24
Last Update Date
2011-11-14
Business Address
Mrs. PHYLLIS A PENGELLY WHNP
2330 NE DIVISION ST SUITE 7
BEND, OR 97701-3530
Phone number: 503-775-4931
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Mailing Address
Mrs. PHYLLIS A PENGELLY WHNP
3727 NE MARTIN LUTHER KING JR BLVD ATTN: CREDENTIALING
PORTLAND, OR 97212-1112
Phone number: 503-775-4931
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