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Individual

JACKIE J SOCHIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP - CERTIFIED

Contact information

Practice address
790 S. MAIN, MYRTLE CREEK, OR 97457
(541) 860-4070
(541) 860-5032
Mailing address
544 W. UMPQUA ST, SUITE 101, ROSEBURG, OR 97471
(541) 672-9596
(541) 464-3519

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP87-006827-7
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
168395
OR
01
R103163
MEDICARE PART B
OR
Enumeration date
04/23/2007
Last updated
01/08/2009
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