Individual
SURAJA SHRESTHA BASTOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
2845 MORNING VIEW DR, MEDFORD, OR 97504-5944
(248) 571-2787
Mailing address
2845 MORNING VIEW DR, MEDFORD, OR 97504-5944
(248) 571-2787
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201907141RN
OR
363L00000X
Nurse Practitioner
Primary
10006717
OR
Other
Enumeration date
11/28/2022
Last updated
12/05/2023
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