Organization
MODERN NOSE CLINIC LLC
Active
Parent organization
MODERN NOSE CLINIC LLC
Other names
Modern Nose Clinic LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MODERN NOSE CLINIC LLC
Authorized official
DR. DOUGLAS SKARADA (MEDICAL DIRECTOR)
(503) 584-1174
Entity
Organization
Contact information
Practice address
340 VISTA AVE SE STE 100, SALEM, OR 97302-4546
(503) 584-1174
(503) 584-1330
Mailing address
340 VISTA AVE SE STE 100, SALEM, OR 97302-4546
(503) 584-1174
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
04/30/2019
Last updated
04/30/2019
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