Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 200950061NP | OR |
NPI | 1093774655 |
---|---|
Provider Name | Deborah Vega |
First Address | Eugene, OR 97401-3273 |
Second Address | Eugene, OR 97401-3273 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2006 |
Last Update Date | 23/09/2009 |