Individual
MS. ELLEN M MONTAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3957 SHANIKO CT SE, SALEM, OR 97302-1717
(503) 391-7130
Mailing address
PO BOX 4374, SALEM, OR 97302-8374
(503) 391-7130
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
3292
OR
Other
Enumeration date
09/07/2010
Last updated
09/07/2010
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