Individual
ANDAESHA K'TREVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1920 CHEMEKETA ST NE, SALEM, OR 97301-4368
(503) 884-7873
Mailing address
PO BOX 6106, SALEM, OR 97304-0278
(503) 884-7873
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10539
OR
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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