Organization
CENTRAL OREGON ENT LLC - EAR NOSE THROAT AND FACIAL PLASTIC SURGEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELLY L WALDEN BUSINESS OFFICE (PRACTICE MANAGER)
(541) 312-6798
Entity
Organization
Contact information
Practice address
2450 NE MARY ROSE PL, SUITE 120, BEND, OR 97701-7132
(541) 312-6799
(541) 312-7050
Mailing address
2450 NE MARY ROSE PL, SUITE 120, BEND, OR 97701-7132
(541) 312-6799
(541) 312-7050
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286653
—
OR
Enumeration date
08/02/2006
Last updated
01/17/2024
Update your record
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