Individual
MRS. SALLY ANN SHIPSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1775 THOMPSON RD, COOS BAY, OR 97420-2125
(541) 269-8045
Mailing address
1389 BUTLER RD, COOS BAY, OR 97420-2004
(541) 267-3827
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
404608
OR
Other
Enumeration date
11/10/2006
Last updated
07/08/2007
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