Individual
JESSICA ANN SPANBAUER-BALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
900 NE 27TH ST, BEND, OR 97701-9548
(541) 382-0479
Mailing address
61266 HUCKLEBERRY PL, BEND, OR 97702-3357
(541) 550-8338
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
202004906NP-PP
OR
Other
Enumeration date
06/25/2020
Last updated
06/25/2020
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