Individual
MARK COREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
110 MAIN ST, MORO, OR 97039-3080
(541) 565-3325
(541) 565-3617
Mailing address
PO BOX 186, MORO, OR 97039-0186
(541) 565-3325
(541) 565-3617
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
Primary
093007080N1
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023015
—
OR
Enumeration date
11/08/2005
Last updated
03/27/2014
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