| NPI | 1700318755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVETTE GAYNOR Nurse Practitioner 541-923-3970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OR 200550094NP) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2017-03-29 |