| NPI | 1780048124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARISSA STULTS Business Manager 541-890-5217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: OR 201500652NP-PP) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2016-05-18 |