Basic Information
| Provider Information | |||||||||
| NPI: | 1548758709 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OBREGON | ||||||||
| FirstName: | LUCIA | ||||||||
| MiddleName: | ESMERALDA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 589 NW 11TH ST | ||||||||
| Address2: | |||||||||
| City: | HERMISTON | ||||||||
| State: | OR | ||||||||
| PostalCode: | 978386600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5415671717 | ||||||||
| FaxNumber: | 5415645994 | ||||||||
| Practice Location | |||||||||
| Address1: | 589 NW 11TH ST | ||||||||
| Address2: | |||||||||
| City: | HERMISTON | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97838 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5415671717 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2018 | ||||||||
| LastUpdateDate: | 02/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 201804989NP-PP | OR | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | 201803811RN | OR | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | 95017814 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.