Individual
HOLLY SUE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
456 SW MONROE AVE, CORVALLIS, OR 97333-4781
(541) 791-3411
Mailing address
238 3RD AVE SE, ALBANY, OR 97321-2857
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000003554
OR
Other
Enumeration date
12/30/2019
Last updated
12/30/2019
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