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Individual

NATHAN SHAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
550 RIVER RD, EUGENE, OR 97404-3212
(541) 505-5479
Mailing address
90 COMMONS DR APT 107, EUGENE, OR 97401-8918

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
EN500W6A
OR
Enumeration date
06/03/2016
Last updated
06/03/2016
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Product
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  • EDI platform