Individual
TRAVIS SIDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
585 S 48TH ST, SPRINGFIELD, OR 97478-6754
(808) 392-4564
Mailing address
585 S 48TH ST, SPRINGFIELD, OR 97478-6754
(808) 392-4564
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
201701635RN
OR
Other
Enumeration date
08/07/2025
Last updated
08/07/2025
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