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General NPI Number Information
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NPI Number | 1356006233
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Entity Type | Individual
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Provider Name | JESSICA BLISS
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Gender | Female
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Dates
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Enumeration Date | 11/04/2021
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Last Update Date | 11/04/2021
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Provider Practice Location Address
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Address Line | SANTIAM MEMORIAL HOSPITAL 1410 N 10TH AVE
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City | STAYTON
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State | OR
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Zip | 97383
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Country | US
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Telephone | 503-769-2175
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Fax |
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Provider Business Mailing Address
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Address Line | 1435 NW GREENWOOD PL
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City | CORVALLIS
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State | OR
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Zip | 97330-1827
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Country | US
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Telephone | 541-231-2671
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number |
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License Number State |
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