Individual
MRS. ANN M GOULD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
374 OWENS ST SE, STE 100, SALEM, OR 97302-4183
(503) 399-1400
(503) 399-1406
Mailing address
PO BOX 883, SALEM, OR 97308-0883
(503) 399-1400
(503) 399-1406
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00824
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500607877
—
OR
Enumeration date
07/20/2007
Last updated
11/29/2016
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