Organization
LIVING WATERS FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CYNTHIA MAHONEY FNP (OWNER)
(541) 474-9400
Entity
Organization
Contact information
Practice address
181 NW BUNNELL AVE, GRANTS PASS, OR 97526-6012
(541) 474-9400
(541) 474-2232
Mailing address
181 NW BUNNELL AVE, GRANTS PASS, OR 97526-6012
(541) 474-9400
(541) 474-2232
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200250078NP
OR
Other
Enumeration date
05/27/2011
Last updated
05/27/2011
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