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1770932097
HALLIE IVERSEN
MEDFORD, OR
NPI
1770932097
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163WP0808X Registered Nurse, Psych/Mental Health
(Licence: OR 201408131)
Enumeration Date
2016-06-07
Last Update Date
2017-03-01
Business Address
HALLIE IVERSEN
100 E MAIN ST STE C
MEDFORD, OR 97501-6041
Phone number: 541-200-2900
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Mailing Address
HALLIE IVERSEN
3587 HEATHROW WAY
MEDFORD, OR 97504-4004
Phone number: 541-858-8170
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