Individual
DAISY CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CHW
Contact information
Practice address
54771 MCKENZIE HWY, BLUE RIVER, OR 97413-9790
(541) 822-3341
Mailing address
54771 MCKENZIE HWY, BLUE RIVER, OR 97413-9790
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
OR
Enumeration date
12/30/2022
Last updated
12/30/2022
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