Individual
MARIANITATA JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5166 SW MEADOW FLOWER DR, CORVALLIS, OR 97333-1186
(541) 730-2303
Mailing address
929 E GRANT ST, LEBANON, OR 97355-4400
(541) 730-2303
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201906549RN
OR
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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