Individual
JAMIE TESSARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1160 LIBERTY ST SE, SALEM, OR 97302-4143
(503) 391-9762
Mailing address
4311 WAVERLY DR NE, ALBANY, OR 97321-7348
(541) 619-9606
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10010415
OR
Other
Enumeration date
07/24/2024
Last updated
07/24/2024
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