Organization
PAT WIDENOJA FNP
Active
Other names
North Lake Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA D WIDENOJA FNP, DNP (OWNER)
(541) 576-2343
Entity
Organization
Contact information
Practice address
87520 BAY RD, POB 377, CHRISTMAS VALLEY, OR 97641-0377
(541) 576-2343
(541) 576-2869
Mailing address
POB377, 87520 BAY RD, CHRISTMAS VALLEY, OR 97641
(541) 576-2343
(541) 576-2869
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
078041667
OR
Other
Enumeration date
03/20/2015
Last updated
03/20/2015
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