Individual
YAHSOLAIT ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LE
Contact information
Practice address
3575 DONALD ST STE 170, EUGENE, OR 97405-4783
(541) 525-1611
Mailing address
3575 DONALD ST STE 170, EUGENE, OR 97405-4783
(541) 525-1611
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
BAP-E-10185660
OR
Other
Enumeration date
04/27/2020
Last updated
04/27/2020
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