Healthcare Provider Details

I. General information

NPI: 1932520160
Provider Name (Legal Business Name): MARY KUHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2013
Last Update Date: 12/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1913 MEADE ST
NORTH BEND OR
97459-3432
US

IV. Provider business mailing address

715 SW RAMSEY AVE
GRANTS PASS OR
97527-5500
US

V. Phone/Fax

Practice location:
  • Phone: 541-756-4508
  • Fax:
Mailing address:
  • Phone: 541-956-5463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: