Individual
AMBER MUDONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
182 SW ACADEMY ST, DALLAS, OR 97338-1996
(503) 623-9289
Mailing address
3587 LIBERTY RD, DALLAS, OR 97338
(971) 716-6941
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/11/2023
Last updated
10/28/2024
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