Individual
JENS MONROE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4075 32ND PL NE, SALEM, OR 97301-6754
(503) 990-6442
(503) 990-6442
Mailing address
3188 LADD AVE NE, SALEM, OR 97301-1748
(503) 560-9091
(503) 990-6442
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
519113
OR
Other
Enumeration date
07/01/2015
Last updated
07/01/2015
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