Individual
MRS. RASIA MYKONO SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
151 W 7TH AVE, EUGENE, OR 97401-1100
(541) 682-3550
Mailing address
2128 GARFIELD ST, EUGENE, OR 97405-1547
(541) 232-8900
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201030371LPN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201030371LPN
LPN LICENSURE
OR
Enumeration date
12/05/2011
Last updated
12/05/2011
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