| Mari Dominguez, NP-C | |
|
506 Fourth St., La Grande, OR 97850 | |
| (541) 663-3138 | |
| Not Available |
| Full Name | Mari Dominguez |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 3 Years |
| Location | 506 Fourth St., La Grande, Oregon |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265197040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 202111998NP-PP (Oregon) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Winding Waters Medical Clinic | 8224346713 | 18 |
| Entity Name | Winding Waters Medical Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922475219 PECOS PAC ID: 8224346713 Enrollment ID: O20160113000362 |
| Mailing Address | Practice Location Address |
|---|---|
| Mari Dominguez, NP-C Po Box 3290, La Grande, OR 97850 Ph: (541) 963-1883 | Mari Dominguez, NP-C 506 Fourth St., La Grande, OR 97850 Ph: (541) 663-3138 |
Jennifer Marie Province, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1 University Blvd, La Grande, OR 97850 Phone: 541-962-3803 | |
Dr. Gary Robert Laustsen, FNP, PHD Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1 University Blvd, La Grande, OR 97850 Phone: 541-962-3132 | |
Heather Wiggins, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1 University Blvd, La Grande, OR 97850 Phone: 541-962-3825 | |
Scott Alden Widener, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 900 Sunset Dr, La Grande, OR 97850 Phone: 541-963-1412 Fax: 541-963-1488 | |
Jacqui Kleeman, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 101 Depot St, La Grande, OR 97850 Phone: 541-963-3772 | |
Ms. Jessica Eileen Martin, MSN, RN, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 506 4th St, La Grande, OR 97850 Phone: 541-663-3138 | |
Korreene Ann Dubray, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 900 Sunset Dr, La Grande, OR 97850 Phone: 541-963-8421 |