Individual
RITA GILLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MPH
Contact information
Practice address
3180 CENTER ST NE, SALEM, OR 97301-4532
(503) 588-5621
(503) 588-2920
Mailing address
2210 NW EVERETT ST APT 404, PORTLAND, OR 97210-5594
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201040887RN
OR
Other
Enumeration date
06/29/2010
Last updated
06/29/2010
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