Individual
KRISTI SOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2925 RYAN DR SE, SALEM, OR 97301-9687
(541) 905-7280
Mailing address
1160 SCOTT CT, INDEPENDENCE, OR 97351-9668
(541) 905-7280
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/04/2019
Last updated
10/04/2019
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