Individual
MS. AUTUMN LYN WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
417 LANCASTER DR NE, SALEM, OR 97301-4729
(503) 371-4968
Mailing address
417 LANCASTER DR NE, SALEM, OR 97301-4729
(503) 371-4968
Taxonomy
Speciality
Code
Description
License number
State
175L00000X
Homeopath
Primary
LMT 17282
OR
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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