Individual
JUAN LUIS CASTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1880 LANCASTER DR NE STE 108, SALEM, OR 97305-1065
(971) 273-0679
(503) 961-0794
Mailing address
1880 LANCASTER DR NE STE 108, SALEM, OR 97305-1065
(971) 273-0679
(503) 961-0794
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201600993NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500706549
—
OR
Enumeration date
01/24/2016
Last updated
03/31/2022
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