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LAWRENCE MICHAEL DIMACALI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1600 STATE ST, SALEM, OR 97301-4257
(503) 540-6300
Mailing address
1600 STATE ST, SALEM, OR 97301-4257
(503) 540-6300
(503) 540-6404

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA190503
OR

Other

Enumeration date
09/19/2016
Last updated
06/10/2019
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