Individual
BETHANY WACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RRT
Contact information
Practice address
2000 BROOKHURST ST APT 13, MEDFORD, OR 97504-5446
(541) 220-8135
Mailing address
2000 BROOKHURST ST APT 13, MEDFORD, OR 97504-5446
(541) 220-8135
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
RTP047707
OR
Other
Enumeration date
10/04/2016
Last updated
10/04/2016
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