Individual
MARISIA ANNE YBARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N
Contact information
Practice address
33142 CAMAS SWALE RD, CRESWELL, OR 97426-9732
(541) 510-3919
Mailing address
219 HUNSAKER LN, EUGENE, OR 97404-2477
(541) 521-7176
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201601737LPN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
695514
SENIOR AND DISABLED SERVICES
OR
Enumeration date
03/22/2016
Last updated
03/22/2016
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