Organization
SAGE ADULT AND GERIATRIC PRIMARY CARE LLC
Active
Organization
SAGE ADULT AND GERIATRIC PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NINA VAN ES ANP/GNP (OWNER)
(541) 296-4804
Entity
Organization
Contact information
Practice address
1015 WEBBER ST STE 100, THE DALLES, OR 97058-3527
(541) 296-4804
(541) 296-3741
Mailing address
1015 WEBBER ST STE 100, THE DALLES, OR 97058-3527
(541) 296-4804
(541) 296-3741
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
200150061NP
OR
363LG0600X
Gerontology Nurse Practitioner
Primary
200150060NP
OR
Other
Enumeration date
11/30/2016
Last updated
11/30/2016
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