Individual
PAULA SOUTHWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 4TH ST, BAKER CITY, OR 97814-2615
(541) 523-3646
Mailing address
2200 4TH ST, BAKER CITY, OR 97814-2615
(541) 523-3646
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014274
—
OR
Enumeration date
07/24/2009
Last updated
07/24/2009
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