| NPI | 1407200132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY RATHER Administrator 541-431-9501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201602016NP-PP) |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2016-04-19 |