Individual
ELIZABETH NIERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1364 NW DAVENPORT AVE, BEND, OR 97703-3077
(541) 410-0909
Mailing address
1364 NW DAVENPORT AVE, BEND, OR 97703-3077
(541) 410-0909
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
20836
OR
174400000X
Specialist
Primary
20836
OR
Other
Enumeration date
03/09/2016
Last updated
03/09/2016
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