Individual
MRS. MICHELLE MARIE MOTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
518 68TH PL, SPRINGFIELD, OR 97478-7139
(541) 654-2649
Mailing address
518 68TH PL, SPRINGFIELD, OR 97478-7139
(541) 654-2649
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201230523LPN
OR
Other
Enumeration date
11/27/2012
Last updated
11/27/2012
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