Doctor Name: | MRS. JESENIA GUZMAN |
NPI Number: | 1043592009 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CMA |
License Number: | |
Business Practice Address: | 412 Ne Ford St Mcminnville, OR - 97128 |
Business Phone Number: | 5034347525 |
Business Fax Number: | 5034729731 |
Mailing Address: | 412 Ne Ford St, MCMINNVILLE |
State: | OR |
Postal Code: | 97128 |
Phone Number: | 5034347525 |
Fax Number: | 5034729731 |
NPI Enumeration Date: | 09/15/2011 |
NPI Last Update Date: | 09/15/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251K00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Public Health or Welfare |
Taxonomy Specialization: | |
Taxonomy Definition: |