Individual
MISS RANA MCCOLLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1599 STATE ST, SALEM, OR 97301-4255
(503) 363-3260
Mailing address
1243 PEACE ST SE, SALEM, OR 97302-2549
(503) 576-0965
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KWA4451C
OHP
OR
Enumeration date
08/09/2018
Last updated
08/09/2018
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