Individual
OLIVIA LOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHW
Contact information
Practice address
442 SW UMATILLA AVE, REDMOND, OR 97756-7039
(866) 931-3414
Mailing address
63140 BRITTA ST STE D104, BEND, OR 97703-5738
(866) 931-3414
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
105871
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
THW000105871
—
OR
Enumeration date
12/07/2021
Last updated
12/27/2022
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