Individual
MARIANA LUPITA FLORES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3950 17TH ST STE A, BAKER CITY, OR 97814-1300
(541) 523-1001
(541) 523-1152
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA223319
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/06/2022
Last updated
02/05/2025
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