Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 20171 | OR |
NPI | 1982003448 |
---|---|
Provider Name | Kayce Jones |
First Address | North Bend, OR 97459-1450 |
Second Address | Coos Bay, OR 97420-2050 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2014 |
Last Update Date | 20/08/2014 |