Individual
ELOISE ROOT JR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2326 SW GLACIER PL, REDMOND, OR 97756-7626
(541) 516-0669
(541) 516-0669
Mailing address
2326 SW GLACIER PL, REDMOND, OR 97756-7626
(541) 516-0669
(541) 516-0669
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
113842
OR
Other
Enumeration date
04/23/2025
Last updated
04/23/2025
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