Individual
KAIWI RUTH VALENTINE MURDOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPSS
Contact information
Practice address
1913 MEADE ST, NORTH BEND, OR 97459-3432
(541) 479-5901
Mailing address
715 SW RAMSEY, AVENUE, GRANTS PASS, OR 97527
(541) 479-5901
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R58765252
BLUE CROSS BLUE SHIELD
—
Enumeration date
05/27/2017
Last updated
06/26/2017
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