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Individual

LAVENA H MCCULLUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
401 RATCLIFF DR SE STE 110, SALEM, OR 97302-4576
(541) 224-8110
(800) 783-8942
Mailing address
710 E FOOTHILLS DR STE 104, NEWBERG, OR 97132-6125
(541) 224-8110
(800) 783-8942

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10021776
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71007953A
IN

Other

Enumeration date
05/02/2018
Last updated
04/21/2026
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