Individual
JUDY NAOMI GERVAIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, AAS
Contact information
Practice address
356 SW 6TH ST, REDMOND, OR 97756-2201
(541) 420-0072
Mailing address
356 SW 6TH ST, REDMOND, OR 97756-2201
(541) 420-0072
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10788
OR
Other
Enumeration date
04/06/2007
Last updated
07/08/2007
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