Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FC0800X | Contact Lens |
NPI | 1942473277 |
---|---|
Provider Name | Ms. Janelle Marla Oliger-Graham |
First Address | Albany, OR 97322 |
Second Address | Albany, OR 97322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2008 |
Last Update Date | 08/04/2008 |