Individual
CORA MAY HAZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
509 E MAIN ST, ROGUE RIVER, OR 97537-9674
(541) 582-0505
(541) 582-0778
Mailing address
PO BOX 1020, ROGUE RIVER, OR 97537-1020
(541) 582-0505
(541) 582-0778
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00956
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000
—
OR
Enumeration date
06/12/2006
Last updated
05/14/2019
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