Organization
MAURICE COLLADA JR. MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHRISTY SPAETH (OFFICE MANAGER)
(503) 581-5517
Entity
Organization
Contact information
Practice address
1344 LIBERTY ST SE, SALEM, OR 97302-4283
(503) 581-5517
(503) 581-6341
Mailing address
1344 LIBERTY ST SE, SALEM, OR 97302-4283
(503) 581-5517
(503) 581-6341
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD13614
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103728
MEDICARE
—
Enumeration date
10/29/2007
Last updated
07/27/2010
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