Individual
BETHANEE NICEWANER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4455 NE HIGHWAY 20, CORVALLIS, OR 97330-9695
(541) 758-5900
Mailing address
142 E ELMORE ST APT H21, LEBANON, OR 97355-4814
(503) 999-6646
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
08/08/2022
Last updated
08/08/2022
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