| NPI | 1932642568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NINA VAN ES Owner 541-296-4804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OR 200150060NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 200150061NP) |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2016-11-30 |