Individual
LAURA BAKKENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
348 RUBY AVE, EUGENE, OR 97404-2033
(541) 461-3075
Mailing address
348 RUBY AVE, EUGENE, OR 97404-2033
(541) 461-3075
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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