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Individual

KAYLEEN R WALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
HIS

Contact information

Practice address
1284 MARILYN ST SE, SALEM, OR 97302-1576
(360) 947-6464
Mailing address
1284 MARILYN ST SE, SALEM, OR 97302-1576
(360) 947-6464

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HASP10145895
OR

Other

Enumeration date
06/11/2024
Last updated
06/11/2024
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