Individual
STELLA NAI PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3871 FAIRVIEW INDUSTRIAL DR SE, SUITE 150, SALEM, OR 97302-1180
(503) 391-9762
(503) 315-2019
Mailing address
3871 FAIRVIEW INDUSTRIAL DR SE, SUITE 150, SALEM, OR 97302-1180
(503) 391-9762
(503) 315-2019
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201406159LPN
OR
Other
Enumeration date
02/10/2016
Last updated
02/10/2016
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