| NPI | 1588999007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODY AILEEN STARK President 541-889-2244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SF0001X Clinical Nurse Specialist Family Health (Licence: OR 07904) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: OR 200550081NP) |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2009-10-16 |