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Dr. Agatha Song
Specialist in Roseburg, Oregon
NPI 1992925507

Agatha Song is a Specialist based in Roseburg, OR. Agatha Song practices in Roseburg, OR. The NPI Number for Agatha Song is 1992925507 and holds a License No. 25MA04557700 (Oregon).

The current practice location address for Agatha Song is 913 Nw Garden Valley Blvd, Roseburg, OR and can be reached out via phone at 541-440-1377 and via fax at 541-440-1394.

Location: 913 Nw Garden Valley Blvd, Roseburg, OR, 97470-1942
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1992925507
Provider Name
Agatha Song
Credential
Provider Entity Type
Individual
Gender
Female
Address
913 Nw Garden Valley Blvd, Roseburg, OR, 97470-1942
Phone Number
541-440-1377
Fax Number
541-440-1394
Provider Enumeration Date
04/26/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
913 Nw Garden Valley Blvd
City
Roseburg
State
Oregon
Zip
97470-6523
Phone Number
541-440-1377
Fax Number
541-440-1394
person
Provider Business Mailing Address Details
Address
913 Nw Garden Valley Blvd
City
Roseburg
State
Oregon
Zip
97470-6523
Phone Number
541-440-1377
Fax Number
541-440-1394
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
25MA04557700 (New Jersey)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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