Individual
JONATHAN MICHAEL GALLEGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
20370 POE SHOLES DR, BEND, OR 97703-7938
(541) 306-5180
Mailing address
20370 POE SHOLES DR, BEND, OR 97703-7938
(541) 306-5180
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
201800355
OR
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
201800355RN
OR
Other
Enumeration date
01/24/2025
Last updated
01/24/2025
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