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1922599935
STACY GOODWIN
ROSEBURG, OR
NPI
1922599935
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: OR 201709844LPN)
Enumeration Date
2018-05-24
Last Update Date
2018-05-24
Business Address
STACY GOODWIN
621 W MADRONE ST
ROSEBURG, OR 97470-3090
Phone number: 541-492-0241
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Mailing Address
STACY GOODWIN
PO BOX 1121
ROSEBURG, OR 97470-0254
Phone number:
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