Individual
SUPRADTANA NILE PIGROMSUK-VALENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RRT, LPN
Contact information
Practice address
3333 RIVERBEND DR, SACRED HEART MEDICAL CENTER, SPRINGFIELD, OR 97477-8800
(541) 222-2400
Mailing address
710 TYLER ST APT 7, EUGENE, OR 97402-4656
(541) 653-3389
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
201394057LPN
OR
227900000X
Registered Respiratory Therapist
Primary
RTP10137640
OR
Other
Enumeration date
02/25/2015
Last updated
02/25/2015
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