Organization
IRIDESCENT WELLNESS CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RANDA JILL KUCEY DNP (FNP/OWNER)
(503) 739-5705
Entity
Organization
Contact information
Practice address
1907 GARDEN AVE STE 203, EUGENE, OR 97403-1965
(503) 739-5705
Mailing address
2312 W 28TH AVE, EUGENE, OR 97405-1426
(503) 739-5705
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/10/2021
Last updated
03/07/2023
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