| NPI | 1720869688 |
|---|---|
| Doing Business As | DR. TRACE WONSER |
| Entity Type | Organization |
| Authorized Contact | TRACY WONSER Operator 541-892-0518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2023-10-06 |
| Last Update Date | 2024-01-10 |