| Patricia Diane Widenoja, BSN, MN, FNP | |
|
85955 Raven Ridge Ln, Silver Lake, OR 97638-9627 | |
| (541) 576-3070 | |
| (541) 576-3070 |
| Full Name | Patricia Diane Widenoja |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 85955 Raven Ridge Ln, Silver Lake, Oregon |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235110628 | NPI | - | NPPES |
| ANP0170 | Other | OR | WORKERS COMPENSATION |
| 051750 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 078041667N1 (Oregon) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Patricia Diane Widenoja, BSN, MN, FNP 85955 Raven Ridge Ln, Silver Lake, OR 97638-9627 Ph: (541) 576-3070 | Patricia Diane Widenoja, BSN, MN, FNP 85955 Raven Ridge Ln, Silver Lake, OR 97638-9627 Ph: (541) 576-3070 |