Individual
CLARISA SHEPARD-RHODES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
251 NE GARDEN VALLEY BLVD, SUITE 102, ROSEBURG, OR 97470-1498
(541) 440-0933
(541) 440-3707
Mailing address
251 NE GARDEN VALLEY BLVD, SUITE 102, ROSEBURG, OR 97470-1498
(541) 440-0933
(541) 440-3707
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
15-2108
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149192
—
OR
Enumeration date
05/18/2016
Last updated
05/18/2016
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