Individual
JESSICA WALDROFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
565 UNION ST NE, SALEM, OR 97301-2477
(503) 949-6668
Mailing address
565 UNION ST NE STE 100, SALEM, OR 97301-2416
(503) 949-6668
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427457928
—
OR
Enumeration date
08/20/2014
Last updated
03/14/2018
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