Provider Demographics
NPI:1285938340
Name:GRABOWSKI, WODENA FAY
Entity type:Individual
Prefix:MRS
First Name:WODENA
Middle Name:FAY
Last Name:GRABOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DENA
Other - Middle Name:FAY
Other - Last Name:GRABOWSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:140 SOUTH HOLLY STREET
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501
Mailing Address - Country:US
Mailing Address - Phone:541-774-8200
Mailing Address - Fax:541-774-7964
Practice Address - Street 1:140 SOUTH HOLLY STREET
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501
Practice Address - Country:US
Practice Address - Phone:541-774-8200
Practice Address - Fax:541-774-7964
Is Sole Proprietor?:No
Enumeration Date:2011-01-04
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator