Individual
MICHAEL JOHN VONDETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
750 FRONT ST NE, SALEM, OR 97301-1089
(503) 363-2021
Mailing address
PO BOX 17818, SALEM, OR 97305-7818
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
22-CRM-1365
OR
Other
Enumeration date
10/21/2022
Last updated
10/21/2022
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