Individual
ANASTACIA ANGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
QMHA
Contact information
Practice address
2421 LANCASTER DR NE, SALEM, OR 97305-1220
(503) 561-2722
(503) 585-4990
Mailing address
4533 ARABIAN CT SE, SALEM, OR 97301-6024
(503) 361-3722
(503) 585-4990
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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