Organization
WILLAMETTE VALLEY TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOBAIL NAVIDA LABILLES (LPN)
(541) 974-1010
Entity
Organization
Contact information
Practice address
3871 FAIRVIEW INDUSTRIAL DR SE, SALEM, OR 97302-1180
(503) 391-9762
Mailing address
3513 SILVERPARK PL NE, SALEM, OR 97305-2012
(541) 974-1010
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201601769LPN
OR
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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