Individual
DESIRAE DAWN RATHBONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AG-ACNP-BC
Contact information
Practice address
2865 DAGGETT AVE, KLAMATH FALLS, OR 97601-1106
(541) 274-6101
(541) 274-6106
Mailing address
PO BOX 2120, PORTLAND, OR 97208-2120
(541) 274-6556
(541) 274-6247
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
10002748
OR
363LA2100X
Acute Care Nurse Practitioner
273896
AZ
Other
Enumeration date
04/20/2022
Last updated
02/10/2023
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