Individual
DARYL GLEN OTTAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3225 STATE STREET, ROOM 249, SALEM, OR 97301
(503) 584-2284
(503) 584-2293
Mailing address
PO BOX 14350, 1776 MILITIA WAY, SALEM, OR 97309-5047
(503) 584-2284
(503) 584-2293
Taxonomy
Speciality
Code
Description
License number
State
163WX0106X
Occupational Health Registered Nurse
Primary
200340189RN
OR
Other
Enumeration date
06/04/2008
Last updated
06/04/2008
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