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Individual

CORINNA RAE BUKOVICS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CD

Contact information

Practice address
403 MERCHANT ST, COOS BAY, OR 97420-4351
(541) 979-2248
Mailing address
403 MERCHANT ST, COOS BAY, OR 97420-4351
(541) 979-2248

Taxonomy

Speciality
Code
Description
License number
State
374J00000X
Doula
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
116033
OR
Enumeration date
06/02/2026
Last updated
06/02/2026
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