Individual
JULISSA MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
565 UNION ST NE STE 101, SALEM, OR 97301-2416
(971) 719-2440
Mailing address
PO BOX 7303, SALEM, OR 97303-0062
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/22/2022
Last updated
03/22/2022
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