Individual
KRISTI LYNN MATTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
506 35TH ST, SPRINGFIELD, OR 97478-5865
(541) 221-8615
Mailing address
506 35TH ST, SPRINGFIELD, OR 97478-5865
(541) 221-8615
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201130241LPN
OR
Other
Enumeration date
05/01/2012
Last updated
05/01/2012
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