Individual
GUSTAVO BLISS MENDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1118 OAK ST SE, SALEM, OR 97301-4019
(503) 585-4949
Mailing address
4438 FERN CT NE, SALEM, OR 97305-2261
(971) 719-5309
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/25/2023
Last updated
08/25/2023
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