Individual
SAMUEL STAN OLIVER-PALMQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2645 PORTLAND RD NE STE 120, SALEM, OR 97301-0200
(503) 390-5637
Mailing address
2645 PORTLAND RD NE STE 120, SALEM, OR 97301-0200
(503) 390-5637
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
T1592
OR
Other
Enumeration date
05/12/2016
Last updated
11/12/2019
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