Individual
LANA TERENE AUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1029 NW 14TH ST STE 101, BEND, OR 97703-2189
(541) 617-1653
(541) 617-1624
Mailing address
3357 NE STONEBROOK LOOP, BEND, OR 97701-8231
(541) 389-2262
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
H2953
OR
251V00000X
Voluntary or Charitable Agency
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Other
Enumeration date
05/23/2019
Last updated
07/08/2019
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