Individual
JOHANNA SIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
530 NW 27TH ST, CORVALLIS, OR 97330-5223
(541) 766-6835
Mailing address
37575 GORE DR, LEBANON, OR 97355-9681
(541) 602-8144
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
2527455
OR
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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