Individual
HALIE GOFFRIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2478 13TH ST SE, SALEM, OR 97302-2546
(503) 362-2481
Mailing address
2478 13TH ST SE, SALEM, OR 97302-2522
(503) 362-2481
(503) 371-7803
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00995
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032458
—
OR
05
—
500636798
—
OR
Enumeration date
05/24/2006
Last updated
05/26/2021
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