Organization
UMPQUA VALLEY WOMENS CARE PC
Active
Other names
La Bella Vita Health & Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN JOEL VANNUCCI (COO/ CFO)
(541) 464-0788
Entity
Organization
Contact information
Practice address
2423 NW TROOST ST, ROSEBURG, OR 97471-1706
(541) 464-0788
(541) 464-0789
Mailing address
2423 NW TROOST STREET, ROSEBURG, OR 97470
(541) 464-0788
(541) 464-0789
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
DO21702
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
067743001
BLUE CROSS
OR
05
—
139406
—
OR
Enumeration date
04/30/2007
Last updated
03/13/2009
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