Individual
SERRIA MARIE WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 GWEE SHUT RD, SILETZ, OR 97380-2036
(541) 819-2518
Mailing address
PO BOX 320, SILETZ, OR 97380-0320
(541) 819-2518
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
3375487
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3375487
—
OR
Enumeration date
12/19/2022
Last updated
12/19/2022
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