Provider Demographics
NPI:1386129294
Name:BIOLATTO, CLAIRE KUGLER (NP)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:KUGLER
Last Name:BIOLATTO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 NW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-1203
Mailing Address - Country:US
Mailing Address - Phone:510-543-4353
Mailing Address - Fax:
Practice Address - Street 1:2065 NE TUCSON WAY APT 110
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-5182
Practice Address - Country:US
Practice Address - Phone:541-383-3005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010062363LF0000X
OR202000932363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily