Individual
NATASSIA MICHELLE CORNELIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1430 GARDEN VALLEY BLVD, ROSEBURG, OR 97471-1766
(541) 673-1750
(541) 672-0584
Mailing address
550 S STATE ST UNIT 140, SUTHERLIN, OR 97479-8521
(541) 515-9661
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
CPT0013204
OR
Other
Enumeration date
08/19/2022
Last updated
08/19/2022
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