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Individual

KELLI MARION SWANSON JAECKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
380 JERRIS AVE SE, SALEM, OR 97302-5278
(503) 315-2222
(503) 315-2248
Mailing address
380 JERRIS AVE SE, SALEM, OR 97302-5278
(503) 315-2222
(503) 315-2248

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H3590
OR

Other

Enumeration date
10/09/2007
Last updated
10/09/2007
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