Individual
TAMMI PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 BROADWAY ST NE STE 403, SALEM, OR 97301-1420
(541) 912-4009
Mailing address
28399 VALLEY VIEW RD, SHEDD, OR 97377-9761
(541) 912-4009
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW0408
OR
Other
Enumeration date
03/24/2016
Last updated
03/24/2016
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