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Individual

JESSICA LUSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1475 CAPITOL ST NE, SALEM, OR 97301-7850
(971) 599-1712
(888) 835-4257
Mailing address
1017 HERMITAGE WAY S APT 15, SALEM, OR 97302-5098

Taxonomy

Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
A0165
OR

Other

Enumeration date
07/12/2019
Last updated
07/12/2019
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