Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | AT-AT-10192029 | OR |
NPI | 1306434055 |
---|---|
Provider Name | Miss Lauren Oaks |
First Address | Hood River, OR 97031-1587 |
Second Address | Hood River, OR 97031-1587 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2021 |
Last Update Date | 08/01/2021 |