Individual
KRYSTAL CHANTEL BUSHNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSS
Contact information
Practice address
2995 RYAN DR SE STE 200, SALEM, OR 97301-5157
(503) 967-1176
Mailing address
2995 RYAN DR SE STE 200, SALEM, OR 97301-5157
(503) 967-1176
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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