Individual
LARA DYANNE MATARRESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4400 SALEM DALLAS HWY NW, SALEM, OR 97304-3338
(503) 991-5091
Mailing address
4400 SALEM DALLAS HWY NW, SALEM, OR 97304-3338
(503) 991-5091
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
OR
Other
Enumeration date
09/15/2025
Last updated
09/15/2025
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