Individual
MRS. JACQUELINE MICHELLE EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
711 SW RAMSEY AVE, GRANTS PASS, OR 97527-5500
(541) 479-5901
(541) 479-6329
Mailing address
715 SW RAMSEY AVE, GRANTS PASS, OR 97527-5500
(541) 479-5901
(541) 479-6329
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/09/2016
Last updated
09/16/2016
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