Individual
VIVIAN ENYO DZATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2073 OLYMPIC ST, SPRINGFIELD, OR 97477-3413
(541) 682-3550
(541) 682-3551
Mailing address
2073 OLYMPIC ST, SPRINGFIELD, OR 97477-3413
(541) 682-3550
(541) 682-3551
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
201602785NP-PP
OR
Other
Enumeration date
06/17/2009
Last updated
07/25/2016
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