Individual
MARYLYN SUMANO CHAMPLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1101 I AVE, LA GRANDE, OR 97850-2043
(541) 962-0162
(541) 962-0119
Mailing address
1101 I AVE, LA GRANDE, OR 97850-2043
(541) 962-0162
(541) 962-0119
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201505941RN
OR
172V00000X
Community Health Worker
—
—
Other
Enumeration date
08/26/2016
Last updated
08/26/2016
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