Individual
MRS. MOLLY AULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9775 SE SUNNYSIDE RD STE 200, CLACKAMAS, OR 97015-5721
(503) 654-8417
Mailing address
PO BOX 864, MOLALLA, OR 97038-0864
(503) 829-9293
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
OR
Other
Enumeration date
12/08/2006
Last updated
07/08/2007
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