Individual
CAROLYN RAE CLONTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1128 NW HARRIMAN STREET, BEND, OR 97703-7565
(541) 322-7500
(541) 322-7565
Mailing address
1130 NW HARRIMAN ST, BEND, OR 97703-1977
(541) 322-7400
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
174H00000X
Health Educator
Primary
1295307486
OR
Other
Enumeration date
07/15/2021
Last updated
07/16/2021
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