Individual
JESSICA MONTALVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3180 CENTER ST NE, SALEM, OR 97301-4592
(503) 588-5342
Mailing address
4592 VERDA LN NE # 2, KEIZER, OR 97303-2445
(503) 980-8446
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
6321825
OR
Other
Enumeration date
08/04/2016
Last updated
08/04/2016
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