Individual
VICTORIA COUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
82771 BRADFORD RD, CRESWELL, OR 97426-9845
(310) 968-8042
Mailing address
82771 BRADFORD RD, CRESWELL, OR 97426-9845
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201030045
OR
Other
Enumeration date
01/13/2015
Last updated
01/13/2015
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