Individual
SVETLANA VITUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 1ST ST, GLENDALE, OR 97442-9640
(541) 832-5400
Mailing address
1701 NE 7TH ST, GRANTS PASS, OR 97526-1319
(541) 471-4106
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
202010121NP-PP
OR
Other
Enumeration date
01/28/2021
Last updated
04/19/2021
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