Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
YESICA BUSTOS-MORAN
ActiveRecreational Therapist Assistant · MEDFORD, OR
Registration Details
- NPI Number
- 1124686167
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 4, 2019 (6.8828535833109 yrs)
- Last Updated
- Jun 4, 2019
- License
-
THW000003305 (OR)
Practice Information
- Address
-
300 W MAIN STMEDFORD, OR, 975012756Browse OR providers · Browse ZIP 97501
- Phone
- 5417721777
- Fax
- 5417342410
- Primary Specialty
-
Recreational Therapist Assistant
246YR1600X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.