Individual
JODI SUE TAVERNIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHW
Contact information
Practice address
1750 THOMPSON RD, COOS BAY, OR 97420-2195
(541) 269-0333
(541) 269-7389
Mailing address
1750 THOMPSON RD, COOS BAY, OR 97420-2195
(541) 269-0333
(541) 269-7389
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OR
Other
Enumeration date
07/21/2020
Last updated
07/21/2020
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