Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 214724 | OR |
NPI | 1023418449 |
---|---|
Provider Name | Miss Lauren Sophia Ricci |
First Address | Eugene, OR 97402-3720 |
Second Address | Eugene, OR 97402-3522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2014 |
Last Update Date | 27/10/2020 |