Individual
GREGORY LEE IVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
615 KOURT DR, EUGENE, OR 97404-2279
(541) 514-4891
(866) 669-7086
Mailing address
615 KOURT DR, EUGENE, OR 97404-2279
(541) 514-4891
(866) 669-7086
Taxonomy
Speciality
Code
Description
License number
State
163WH0500X
Hemodialysis Registered Nurse
Primary
080044735RN
OR
Other
Enumeration date
07/12/2009
Last updated
07/12/2009
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