Individual
JOSHUA JAY HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
155 S EMPIRE BLVD, COOS BAY, OR 97420-3374
(541) 256-4687
Mailing address
1942 SHERIDAN AVE, NORTH BEND, OR 97459-3416
(541) 256-4687
(541) 756-2111
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
20-CRM-012
OR
Other
Enumeration date
01/31/2020
Last updated
01/31/2020
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