Individual
MARY ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
705 HOWARD ST SE, SALEM, OR 97302-3026
(971) 332-0316
Mailing address
705 HOWARD ST SE, SALEM, OR 97302-3026
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
201042572RN
OR
Other
Enumeration date
01/19/2024
Last updated
01/19/2024
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