Individual
JULIE LALENA GRIESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
2964 NE DOUGLAS AVE, ROSEBURG, OR 97470-3726
(541) 680-2008
Mailing address
2964 NE DOUGLAS AVE, ROSEBURG, OR 97470-3726
(541) 680-2008
Taxonomy
Speciality
Code
Description
License number
State
261QP0904X
Federal Public Health Clinic/Center
261QP0904X
OR
261QV0200X
VA Clinic/Center
261QV0200X
OR
314000000X
Skilled Nursing Facility
Primary
314000000X
OR
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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