Individual
AMY L ULLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2441 GREAR ST NE, SALEM, OR 97301-2749
(503) 588-0469
(503) 566-2063
Mailing address
2441 GREAR ST NE, SALEM, OR 97301-2749
(503) 588-0469
(503) 566-2063
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00780
OR
Other
Enumeration date
04/29/2008
Last updated
04/29/2008
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