Individual
MANDY ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CHW
Contact information
Practice address
1111 CRATER LAKE AVE, MEDFORD, OR 97504-6241
(541) 816-7789
Mailing address
1111 CRATER LAKE AVE, MEDFORD, OR 97504-6241
(541) 816-7789
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
108085
OR
Other
Enumeration date
12/11/2024
Last updated
12/11/2024
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