Individual
UN SOK SEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D. UN
Contact information
Practice address
1515 VILLAGE DR, COTTAGE GROVE, OR 97424-9700
(541) 942-0511
(541) 942-0353
Mailing address
PO BOX 569, EUGENE, OR 97440-0569
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD25947
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213550
—
OR
Enumeration date
07/03/2006
Last updated
10/11/2007
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