Individual
GRACE LYNN WATKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
612 SE JACKSON ST STE 11, ROSEBURG, OR 97470-4956
(541) 677-4191
Mailing address
5246 NONPAREIL RD, SUTHERLIN, OR 97479-4718
(541) 459-4089
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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