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Individual

CHRISTINA MASCAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
73265 CONFEDERATED WAY, PENDLETON, OR 97801-0160
(541) 966-9830
Mailing address
78040 LUPINE LN, WESTON, OR 97886-6104
(541) 310-0910

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
200930495LPN
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
171037
OR
Enumeration date
10/18/2010
Last updated
10/25/2010
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