Individual
MADISON NESSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 W AVE, LA GRANDE, OR 97850-3167
(541) 398-1557
Mailing address
2111 TRUE AVENUE, LA GRANDE, OR 97850
(541) 398-1557
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
10029116
OR
Other
Enumeration date
06/23/2025
Last updated
06/23/2025
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