Individual
ROSE FENWICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
341 E 12TH AVE, EUGENE, OR 97401-3275
(541) 342-8255
Mailing address
341 E 12TH AVE, EUGENE, OR 97401-3212
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200399
EMT
OR
Enumeration date
10/19/2024
Last updated
10/19/2024
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