Individual
JUSTIN MOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, MSN
Contact information
Practice address
3180 CENTER ST NE, SALEM, OR 97301-4532
(503) 588-5618
Mailing address
3180 CENTER ST NE, SALEM, OR 97301-4532
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
200940224RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
936002307
MARION COUNTY
OR
Enumeration date
06/01/2017
Last updated
06/01/2017
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