Individual
JORDAN VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4016 OREGON AVE, SPRINGFIELD, OR 97478-6464
(541) 285-3464
Mailing address
4016 OREGON AVE, SPRINGFIELD, OR 97478-6464
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201601622LPN
OR
Other
Enumeration date
04/01/2016
Last updated
04/01/2016
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