Organization
IO WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER SULLIVAN (OWNER)
(541) 246-7200
Entity
Organization
Contact information
Practice address
89166 LIGHTHOUSE WAY, COOS BAY, OR 97420-7649
(541) 245-7200
Mailing address
89166 LIGHTHOUSE WAY, COOS BAY, OR 97420-7649
(541) 245-7200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/16/2022
Last updated
11/21/2022
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