Individual
MRS. TIFFANY TEELE OTTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
3000 MARKET ST NE STE 530, SALEM, OR 97301-1835
(503) 390-5637
Mailing address
2285 WALKER RD NE, SALEM, OR 97305-2655
(503) 585-3752
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OR
Other
Enumeration date
02/10/2007
Last updated
07/08/2007
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