| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1861457384 | BLOME | RANDALL | E | 9605 GRAND RONDE RD | GRAND RONDE | OR | 973479712 | |
| 1518353549 | BROWN | CHRISTOPHER | MICHAEL | 9615 GRAND RONDE RD | GRAND RONDE | OR | 973479712 | |
| 1407839384 | FAIRFAX | CAROLYN | S | 9605 GRAND RONDE RD | GRAND RONDE | OR | 973479712 | |
| 1023534252 | HICINBOTHOM | HEIDI | KATHLEEN | 9605 GRAND RONDE RD | GRAND RONDE | OR | 973479712 | |
| 1215241708 | SAMPSON | ANNETTE | N | 9615 GRAND RONDE RD | GRAND RONDE | OR | 973479712 | |
| 1578101762 | WING | BRIANNA | 9605 GRAND RONDE RD | GRAND RONDE | OR | 973479712 |