IndividualActive
Agatha Song
NPI 1992925507 · Specialist · Roseburg, OR
Provider details
- NPI number
- 1992925507
- Entity type
- Individual
- Primary specialty
- SpecialistOther Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 25MA04557700 (NJ)
Specialties & taxonomies
Other Service Providers
Practice location
913 Nw Garden Valley Blvd
Roseburg, OR 97470-6523
Phone: (541) 440-1377
Fax: (541) 440-1394
Approximate (ZIP-level) locationGet directions
Mailing address
1450 Nw Mulholland Dr
Roseburg, OR 97470-1942
Registry dates
- Enumerated
- 2007-04-26
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.