Individual
ANITA MARIE NORTHCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3321 HAROLD DR NE, SALEM, OR 97305-1339
(503) 399-5597
Mailing address
1195 CLEARVIEW AVE NE APT 9, KEIZER, OR 97303-4684
(503) 463-4244
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
01/02/2008
Last updated
01/02/2008
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