| NPI | 1316107782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA L STARK Office Administrator 541-889-2244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207K00000X Allergy & Immunology |
| 207KA0200X Allergy & Immunology, Allergy | |
| 207Q00000X Family Medicine | |
| 207RI0200X Internal Medicine, Infectious Disease | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2008-06-10 |