Individual
MRS. VICKI LYNN MIRACLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
19824 S BUTTE RD, BEAVERCREEK, OR 97004-8847
(503) 632-7077
(503) 336-1850
Mailing address
19824 S BUTTE RD, BEAVERCREEK, OR 97004-8847
(503) 632-7077
(503) 336-1850
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
090000670RN
OR
Other
Enumeration date
05/30/2008
Last updated
06/02/2008
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