Individual
MS. RITA KOKKORIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLC
Contact information
Practice address
685 NW 5TH ST STE A, CORVALLIS, OR 97330-6462
(541) 757-1761
Mailing address
685 NW 5TH ST STE A, CORVALLIS, OR 97330-6462
(541) 757-1761
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C5027
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14363786
CAQH
OR
01
—
C5027
OREGON BOARD OF LICENSING
OR
Enumeration date
11/06/2018
Last updated
06/11/2019
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