Individual
JOLENE SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
755 NE CIRCLE BLVD UNIT 30, CORVALLIS, OR 97330-4261
(541) 754-7302
(541) 754-7302
Mailing address
755 NE CIRCLE BLVD SPACE 30, CORVALLIS, OR 97330
(541) 754-7302
(541) 754-7302
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
200930298LPN
OR
Other
Enumeration date
05/28/2015
Last updated
05/28/2015
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