Optimal Behavioral Health
Nurse Practitioner, Psych/Mental Health in Shady Cove, OR. Organization (NPI-2).
NPI number1003243296
StatusActive
Last updated in NPPESOct 2, 2013
Details
- NPI
- 1003243296
- Entity type
- Organization (NPI-2)
- Legal business name
- Optimal Behavioral Health
- Organization subpart
- No
- Enumeration date
- Oct 2, 2013
- Last updated
- Oct 2, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 201150137NP | OR | Yes |
Practice location
22297 Highway 62Suite B
Shady Cove, OR 97539-9831
Phone 541-864-0306
Mailing address
Po Box 159Shady Cove, OR 97539-0159
Phone 541-864-0306 · Fax 541-878-2624
Authorized official
Melanie Kabot-Sturos
Owner
5418640306
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