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Individual

MS. ANN W ROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
10 COBURG RD., #201, EUGENE, OR 97401
(541) 726-4686
(541) 726-5056
Mailing address
10 COBURG RD., #201, EUGENE, OR 97401
(541) 726-4686
(541) 726-5056

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA00290
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
136523
OR
Enumeration date
05/17/2006
Last updated
12/14/2010
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