Individual
CHASTITY VENESA RUTHERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRM
Contact information
Practice address
707 E BROADWAY AVE, MILTON FREEWATER, OR 97862-1318
(541) 938-3988
Mailing address
PO BOX 469, HEPPNER, OR 97836-0469
(541) 676-9161
(541) 676-5662
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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