Provider Demographics
NPI:1407041320
Name:PUENTES, ARNULFO JR
Entity Type:Individual
Prefix:MR
First Name:ARNULFO
Middle Name:JR
Last Name:PUENTES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JR
Other - Middle Name:
Other - Last Name:PUENTES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4422 NE DEVILS LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97367-5000
Mailing Address - Country:US
Mailing Address - Phone:541-557-2700
Mailing Address - Fax:541-994-0261
Practice Address - Street 1:4422 NE DEVILS LAKE BLVD
Practice Address - Street 2:
Practice Address - City:LINCOLN CITY
Practice Address - State:OR
Practice Address - Zip Code:97367-5000
Practice Address - Country:US
Practice Address - Phone:541-557-2700
Practice Address - Fax:541-994-0261
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator