Individual
NICOLE SEQUOIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5135 SKYLINE RD S, SALEM, OR 97306-9427
(503) 588-6560
Mailing address
5135 SKYLINE RD S, SALEM, OR 97306-9427
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
03/28/2016
Last updated
03/28/2016
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