Individual
S SCOTT HAYNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1160 LIBERTY ST SE, SALEM, OR 97302-4143
(503) 315-2019
Mailing address
1160 LIBERTY ST SE, SALEM, OR 97302-4143
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201607185LPN
OR
Other
Enumeration date
12/11/2024
Last updated
12/11/2024
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